What is irritable bowel syndrome (IBS)?
Irritable bowel syndrome (IBS) or colon irritabile is a chronic intestinal disorder, wherein the motility (peristalsis) of the intestinal system is disturbed chronic. Under normal circumstances the intestines sure kneaded and food is transported. In the IBS go movements of the bowel is too fast or too slow. This is accompanied by abdominal symptoms combined with abnormal bowel movements. The symptoms may subside with defecation or change when the stool changes. IBS can have a major impact on one's life. IBS patients often experience misunderstanding and social problems.
For irritable bowel syndrome no specific cause can be found. Some people therefore prefer to speak of unexplained abdominal discomfort.
Appearance
Irritable bowel syndrome is the most common chronic intestinal disease. About 5 to 20% of Belgian and Dutch men and 15 to 20% of women have IBS. 75% of patients are women. Half of the patients are younger than 35 when diagnosed, and another 40% are in the age group between 35 and 50 years.
Irritable bowel syndrome symptoms
The symptoms of irritable bowel syndrome vary from person to person and even from one person the symptoms can still weather from day to day. Sometimes people have symptoms for months, followed by symptom-free periods, after which the symptoms can strike up again. The complaints include classic towards the evening. Also at night can prevent abdominal pain and other symptoms.
Abdominal pain. The most characteristic symptom of IBS is a nagging, convulsive or stabbing pain in the abdomen. Pain can be felt in many places in the abdomen (but often left) and sometimes decreases after a bowel movement, sometimes after meals. The pain can be very severe and interfere with daily activities.
Abnormal bowel habits. IBS is associated with a different relief pattern, for example, diarrhea, constipation (constipation) or a sudden non-sustainable pressure, with or without diarrhea. Others have a bowel pattern with diarrhea and constipation alternate. Also, the relief pattern may change during the day.
Gas accumulation in the stomach (farmers) and intestines (flatulence).
Diagnosis
The diagnosis of irritable bowel syndrome is made by a doctor, and is usually obtained by the exclusion of diseases with a similar pattern of symptoms, such as a gastrointestinal tumor, Crohn's disease, ulcerative colitis, endometriosis, and other conditions.
Because the symptoms of IBS are very similar to those of other disorders, it may take some time before the diagnosis is made. On the other hand IBS is so common that they very soon will have a suspect.
As a tool for physicians prepared in 2007, the Rome III criteria (2007). This is a list compiled by an international team of specialists criteria patients must meet in order to make the diagnosis.
- There exist for a long time (several months) symptoms of abdominal pain, combined with altered bowel habits.
- The shape diarrhea, constipation, the shape and form, the mixing can be based on a simple classification, which is based on how the stool looks like.
- Abnormal stools or defecation. This may include: abnormal frequency (more than 3 times per day or less than 3 times per week), abnormal stools (extra hard, loosely or watery) or abnormal stool passage (straining during defecation, continued strong pressure, feeling of incomplete emptying)
- Mucus in the stool
- Bloating or abdominal distension
The Rome III criteria was also prepared a table of alarming indications, previously indicate an underlying organic cause for which further research is absolutely necessary.
- Blood in the stool or an indication of anemia
- Weight Loss
- Fever
- Physical abnormalities
- Gastroscopy or colonoscopy
- CT-scan
- Blood tests
- Faeces
What causes irritable bowel syndrome?
The causes of irritable bowel syndrome are still unclear. In the intestine, are usually not visible abnormalities to be found. This makes the diagnosis and treatment extremely difficult. It is important that doctors and patients be aware that a medical cause on the head can be seen.
Doctors send patients with IBS often without much explanation home. The condition is described as functional because no specific cause is found.
Possible causes of IBS could be:
- Movement disorders in the gastrointestinal tract
- Dietary factors
- Lowered pain threshold in the gastro-intestinal tract
- Abnormalities in the intestinal flora
- Shortage of serotonin
- Inflammatory cells in the gut
- Parasites
- Lack of soluble fiber in the diet
- Psychosocial factors such as stress, anxiety, or do not listen to the biological clock. In the intestine, serotonin is responsible for signal transmission to the cells that are involved in the intestinal motility. Same substance plays an important role in the development of mood and anxiety disorders. In IBS patients, there is a much higher percentage of depression and excessive anxiety perception than in the rest of the population.
- Gastro-intestinal infection. Sometimes the symptoms can begin after a past gastrointestinal infection, such as a salmonella infection. By traveling walk to other countries (young) people quickly intestinal infections, which locally are often treated with antibiotics. Back in the homeland remain intestinal problems often persist, especially in people who have stressful jobs and / or lead a very busy life. After a period of time is often diagnosed with IBS.
- Food allergy and food intolerance. Some experts assume that food intolerance plays a role. Examples of this are gluten-intolerance and lactose-intolerance.
Irritable bowel syndrome treatment
For IBS is not yet found a satisfactory treatment. The treatment is usually looking at diet and regimen. However, since 1995 in the Netherlands known that IBS can be treated with hypnotherapy combined with specially designed exercise. To date, this form of treatment is most effective with a result of reduction in the complaints between 80% and 100%. This program is called the Gut-Management Program. This because the symptoms after the treatment itself can be controlled by the client. In England, where the program was developed in the 80s, this approach is hypnotherapy the Sense of a Quiet Mind mentioned.
Irritable bowel syndrome medication
Drugs that weaken the peristalsis (antispasmodic), as mebeverine, according to the scientific literature have little effect in IBS. Several studies have found no evidence for the effectiveness of these drugs. Nevertheless, these are frequently prescribed.
That sometimes help these agents may be due to the placebo effect, which may play a role in the treatment of irritable bowel syndrome. 30 to 80 percent of the participants in clinical trials, short saw reduce their symptoms in response to a fake. MRI scans of the brains confirm the powerful effect of placebo at this syndrome.
Also soluble fiber, antacids (prescribed in 21% of cases), painkillers (19%), antidiarrheals, laxatives and antidepressants (serotoninemodulatoren) be prescribed by doctors in IBS.
Food and dietary supplements
Because irritable bowel syndrome a disease of the digestive system appears to be in front of the hand is the search to a treatment method in the power supply. In addition, some supplements may be effective.
- Food that is often avoided by IBS: Besides the known gas-producing products such as cabbage, legumes, onions and carbon dioxide, the IBS patient often avoids fat, dairy products, coffee and sugar, because experience shows that these symptoms may worsen. Earlier research had shown that avoiding lactose-containing foods and citrus fruits can affect the symptoms favorable.
- Soluble fiber. Patients would benefit according to a 2009 study by the addition of soluble fiber to the diet. The soluble fiber in fruits and vegetables may reduce abdominal pain in IBS. Soluble fibers are broken down by the intestinal flora. The substances which are released, such as short chain fatty acids, the normalization of bowel function would be beneficial. As a dietary supplement are soluble fibers available in the form of psyllium husks (Plantago afra, a plantain species). Insoluble fiber, such as those found in wheat bran (wholemeal bread), have in many patients with IBS precisely the opposite effect on the intestinal symptoms. They move like a sponge and are not consumed. They can stimulate the bowel, which may explain the worsening of symptoms. Dietary Products (bulking agents) are prescribed in 60% of cases.
- Probiotics. Probiotics also are named as illuminating means. There is still more research is done.
- Peppermint oil. Peppermint oil contains in addition to strong anti-microbial properties as the principal active ingredient menthol, a compound with an anticonvulsant effect. By all means turn out according to scientific research capsules containing peppermint oil the best cure for irritable bowel syndrome. It would work in one in every two or three people. For best results, the capsules should be equipped with an enteric coating.
- Chinese herbs. In one double-blind placebo-controlled study showed an individually tailored herbal blend of Chinese herbs effective than a standard spice blend or a placebo.
As adjunctive therapy proves especially psychotherapy and hypnotherapy a possible option, not only when psychosocial factors play a role in the disease pattern.
Acupuncture and reflexology is not scientifically proven to be effective for irritable bowel syndrome.