Irritable Bowel Syndrome | Symptoms of IBS | Management for IBS

Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) consists of a group of symptoms suggestive of bowel dysfunction in absence of demonstrable organic pathology- also called as spastic colon, mucous colitis or irritable colon.

Causes of Irritable Bowel Syndrome

1. Idiopathic or unknown.
2. Other factors are – IBS following gastroenteritis and food intolerance.
3. Psychological factors – onset of symptoms may be related to episode of acute stress or symptoms exacerbated by stress.

Symptoms of IBS

• IBS is seen more commonly in females around 30 yrs of age.
• Abdominal pain or discomfort
  • Pain is most commonly felt in left or right iliac fossa or both or below umbilical region.
  • Pain is dull or colicky in nature lasting for minutes or hours.
  • Pain may sometimes be food related.
• Bowel disturbances
  • Frequent urge to defecate especially on waking up in morning and after breakfast (morning rush syndrome).
  • Patient may use the word constipation to express the sensation of incomplete defecation or the need to strain for defecation.
  • Passage of mucus in stools is common but never blood.
• Abdominal distension
  • Sense of abdominal fullness is complained by majority of patients and is described usually along with constipation.
  • It is described as a bloating or swelling of lower abdomen which tends to increase throughout the day.

Other symptoms

• Upper gastro intestinal symptoms like nausea, difficulty in swallowing and inability to finish a meal are seen.
• Non gastro intestinal symptoms include gynecological symptoms like dyspareunia or pain during sexual act and urinary frequency and urgency in females.
• Low back pain is the other symptom described which may be referred to thigh.

How to diagnose Irritable Bowel Syndrome

• Routine stool examination I done for amoebae and giardia.
• Sigmoidoscopy and barium enema may be done. Sigmoidoscopy may reveal excessive mucus and marked spasm.

Management of IBS

• The most important component of management is reassurance and psychological support. Reassurance regarding absence of any organic disease.
• Dietary advice should include restriction on foods which are known to aggravate symptoms therefore milk and spicy is to be restricted in patients with diarrhea and legumes and cabbage in those complaining of gas bloat.
• Patients often report relief by eliminating meat from diet.
• High fiber diets are advised in patients complaining of sensation of constipation commercially available ‘isaphgula’ husk preparations can be taken with breakfast and dinner. These add bulk to the stool and may also relieve diarrhea in some patients.
• Drug medication includes antispasmodics for pain, anti diarrhea agents like loperamide, Tranquillizers in patients with symptoms produced due to anxiety.

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