Have you suddenly felt uncomfortable with a sharp abdominal cramp and felt like running to the washroom after eating out? You may be having Irritable bowel syndrome (IBS) which is a common disorder that affects the large intestine (colon). IBS is a chronic condition that you will need to manage with long term changes in diet, lifestyle and stress levels, besides exercise, plenty of fluid intake, good sleep, medication and counselling.
Signs and triggers vary from case to case, can be very severe at times, may improve or even disappear completely – not all with this condition react to the same stimuli. We still do not know what exactly causes irritable bowel syndrome, but a variety of factors play a role. Common triggers include certain kinds of food like chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages and alcohol to name a few; stress; hormonal changes; abnormalities in the gastrointestinal nervous system and other illnesses like diarrhoea or bacterial overgrowth.
Common signs and symptoms that accompany Irritable bowel syndrome are cramping, abdominal pain, bloating, gas, diarrhoea, mucus in the stool and constipation. More serious conditions have symptoms like rectal bleeding, abdominal pain that aggravates at night and weight loss. IBS is not known to increase or cause colorectal cancer or change in bowel tissue.
This condition does affect the general quality of life with diarrhoea and constipation, malnourishment due to lack of nutrients as a result of avoiding certain foods, and discouragement and depression that one may not be living life to the fullest.
A visit to the gastroenterologist is a must for a detailed medical history, examination and evaluation. Since there are usually no physical symptoms to diagnose IBS, it becomes critical to rule out other conditions. Medical science does that with the Rome criteria and the Manning criteria. Once the criteria fit , the doctor will prescribe a course of treatment besides additional imaging tests to check any malabsorption problems like Flexible sigmoidoscopy, Colonoscopy, X-ray (radiography), Computerized tomography (CT) scan and Lower GI series; and laboratory tests like Lactose intolerance tests, Breath tests, Blood tests and Stool tests.
Since it’s not clear what causes IBS, treatment is mainly focused on the relief of symptoms so that one can lead a normal life. If symptoms are moderate or severe, one may need more than lifestyle changes besides medications like fiber supplement, anti-diarrheal, anticholinergic and antispasmodic medications, antidepressants and antibiotics, and dietary changes like eliminating high-gas foods, gluten and FODMAPs (which stands for fermentable oligo-, di-, and monosaccharides and polyols which is a type of carbohydrate with fructose, fructans, lactose and others).
There are two medications currently approved for specific cases of IBS – alosetron to relax the colon and allow slow movement of waste through the lower bowel; and lubiprostone to increase fluid secretion in the small intestine to help the passage of stool. Both come with their set of restrictions and side effects.