Irritable Bowel Syndrome
Description:
Irritable Bowel Syndrome, or IBS, is a functional disorder of both the small and large intestines that affects their motility and includes abnormal muscles contractions of the intestines(1). Rapid alterations in the speed of bowel movements disturb the normal passing of gas and waste through the intestines. This causes increased pressure in the bowel to elicit pain and spasm of the musculature(2). IBS is considered the most common GI disorder in the Western World and is often linked to psychosocial factors. History of mental or physical abuse can increase symptoms of IBS(2). Women in early adulthood most commonly experience IBS and it can be associated with painful menstrual cycles. Stress and emotional responses also play a role in the enteric nervous system which controls the gastro-intestinal tract(1,3).
Presentation:
Signs of IBS include painful abdominal cramps, constipation, diarrhea, nausea, vomiting, anorexia, flatulence, and possible foul smelling breath. There may also be reports of white mucus in one’s stools and bloating. Pain may be dull and felt deep with sharp cramps after eating or during the morning with a typical pain pattern consisting of left quadrant pain in the abdominal area. Symptoms may come and go, however pain or discomfort is often relieved after defecation(2).
Diagnostic Criteria:
A patient must meet the Rome I criteria in order to be diagnosed with IBS. This includes 3 months or more of abdominal pain that is relieved after defecation, altered stool frequency, altered stool form (lumpy or watery), altered stool passage (such as urgency), passage of mucus, and bloating(3). A full work-up including lab testing, blood work, liver-function tests, and thyrotropin measurements are conducted and a diagnosis of IBS is suggested when there are no positive findings indicative of a structural disorder. To definitively diagnose IBS, a colonoscopy or flexible sigmoidoscopy is preformed and must come back negative for other signs of dysfunction. Treatments for pain include a change in diet and appropriate medications. Diarrhea is treated as well as constipation in the same fashion(2).