Irritable bowel syndrome

What is irritable bowel syndrome?
Irritable bowel syndrome is probably the most common bowel disorder treated by gastroenterological physicians and surgeons. Other terms that are sometimes used to describe this condition are ‘spastic colon’ and ‘mucus colitis’.

What are the symptoms of irritable bowel syndrome?
The symptoms are often a combination of:

  • abdominal discomfort
  • abdominal distension
  • diarrhoea
  • constipation.

Abdominal discomfort is experienced by most patients at some time, and can occur in any part of the abdomen, but most commonly is in the left side. The discomfort may be aggravated by food, and some people may have intolerance to a particular food.

Other symptoms that may occur include abdominal distension, constipation (with the passage of small, hard, dry, pellet stools), pencil-like stools, or diarrhoea, sometimes with explosive defaecation.

Occasionally mucus alone is passed after defaecation.

What is the cause of irritable bowel syndrome?
The cause of irritable bowel syndrome is unknown, but some patients often show anxiety or stress, and in some instances symptoms can date back to the time of ‘food poisoning’ or ‘gastro’.

Many authorities believe that the condition represents an exaggeration of normal function of the bowel, with disordered or uncoordinated bowel activity. Research into the cause of this condition continues.

How is irritable bowel syndrome investigated?
Irritable bowel syndrome is usually made as a diagnosis of exclusion. This means that other organic pathology must be ruled out, and to do so a variety of bowel investigations - in the office, laboratory department or endoscopy department - be required.

What is the treatment for irritable bowel syndrome?
It is always helpful for a patient to know that the condition is benign, and that cancer has been ruled out.

In some patients, treatment of stress-related factors can also be helpful.

Anti-spasmodic drugs may relieve a number of symptoms, but often have unacceptable side effects, and the dosage must be carefully monitored.

Peppermint oil preparations as well as probiotics have been shown to help a considerable number of sufferers.

Constipation should be avoided, as should excessive diarrhoea. Appropriate medications can be used in these circumstances.

The symptoms of irritable bowel may respond to such treatment, but in many patients they continue to wax and wane in severity, and sometimes spontaneously disappear.

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