IRRITABLE BOWEL SYNDROME
Irritable bowel syndrome (IBS, or spastic colon) is a diagnosis of
exclusion. It is a functional bowel disorder characterized by chronic
abdominal pain, discomfort, bloating, and alteration of bowel habits in
the absence of any detectable organic cause. In some cases, the
symptoms are relieved by bowel movements. Diarrhea or constipation may
predominate, or they may alternate (classified as IBS-D, IBS-C or
IBS-A, respectively). IBS may begin after an infection
(post-infectious, IBS-PI), a stressful life event, or onset of maturity
without any other medical indicators.
Although there is no cure for IBS, there are treatments that attempt to
relieve symptoms, including dietary adjustments, medication and
psychological interventions. Patient education and a good
doctor-patient relationship are also important.
Several conditions may present as IBS including coeliac disease,
fructose malabsorption, mild infections, parasitic infections like
giardiasis, several inflammatory bowel diseases, bile acid
malabsorption, functional chronic constipation, and chronic functional
abdominal pain. In IBS, routine clinical tests yield no abnormalities,
although the bowels may be more sensitive to certain stimuli, such as
balloon insufflation testing. The exact cause of IBS is unknown. The
most common theory is that IBS is a disorder of the interaction between
the brain and the gastrointestinal tract, although there may also be
abnormalities in the gut flora or the immune system.
IBS does not lead to more serious conditions in most patients. However,
it is a source of chronic pain, fatigue, and other symptoms and
contributes to work absenteeism. Researchers have reported that the
high prevalence of IBS, in conjunction with increased costs, produces a
disease with a high social cost. It is also regarded as a chronic
illness and can dramatically affect the quality of a sufferer's life.