• April is IBS (Irritable bowel syndrome) Awareness Month.
• Difficult to talk about, so IBS is under-diagnosed.
• IBS affects nearly 25% of adults.
• $1.6 billion in health-related spending each year in the US.
• IBS is not life-threatening but can cause significant pain and distress.
• No test to definitively diagnose IBS.
• More common in women than men.
• Used to be called, colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel.

 What’s the Problem?

• Irritable bowel syndrome (IBS) is a group of symptoms that occur together, including
  • Repeated pain in your abdomen.
  • Changes in your bowel movements, which may be diarrhea, constipation, or both.
  • No any visible signs of damage or disease in your digestive tract.
• IBS is a functional gastrointestinal (GI) disorder or disorders of gut-brain interactions, related to problems with how your brain and your gut work together.
• The brain-gut interaction causes the gut to be more sensitive and change how the muscles in your bowel contract, leading to pain, bloating, constipation or diarrhea.
• IBS symptom triggers:
  • Foods
  • Stress
  • Emotional arousal
  • GI infections
  • Menstrual periods
  • Gaseous distension
• Type of IBS. For the purpose of treatment, IBS can be divided into three types, based on your symptoms: constipation-predominant, diarrhea-predominant or mixed.

IBS Causes

• Doctors aren’t sure what causes IBS.
• Probably a combination of problems, different factors may cause IBS in different people.
• Certain problems are more common in people with IBS and may play a role in causing IBS.
  • Stressful or difficult early life events, such as physical or sexual abuse.
  • Certain mental disorders, such as depression , anxiety , and somatic symptom disorder.
  • Bacterial infections in your digestive tract.
  • Small intestinal bacterial overgrowth, an increase in the number or a change in the type of bacteria in your small intestine.
  • Food intolerances or sensitivities, in which certain foods cause digestive symptoms.

Diagnosing IBS

• Rome criteria. These criteria include abdominal pain and discomfort lasting on average at least one day a week in the last three months, associated with at least two of these factors:

• • • Pain and discomfort are related to bowel movement.
    • The frequency of bowel movements is altered or stool consistency is altered.

• Manning criteria. These criteria focus on The more of these symptoms you have, the greater the likelihood of IBS.

• • • Pain relieved by passing stool.
    • Having incomplete bowel movements.
    • Mucus in the stool.
    • Changes in stool consistency.

• Rule out other intestinal disorders that can be life threatening:

• • • Ulcerative colitis
    • Crohns disease
    • Bowel infection
    • Bowel cancer

Treatments for IBS

• Lifestyle changes
  • Minimize any dietary or stress-related factors in your life.
  • Refrain from eating foods that brings on IBS symptoms, keep a food diary to help you track the foods that bring on symptoms.
  • If IBS happens after eating, try eating smaller meals or eating more frequently.
• Medicines
  • Anti-diarrheal agents (lomotil).
  • Antispasmodics (dicyclomine, hyoscyamine) –need prescription.
  • Laxatives can help with constipation but not pain. Use under the supervision of a physician.
  • Anti-anxiety medications ( remember gut also contains a large nervous system so meds may be working directly on neurons not necessarily on anxiety).
• Fitness & Nutrition
  • Changing the flora in your gut through ‘probiotic’ diet.
  • 30 minutes of exercise can ease constipation and abdominal pain.
  • Changing food choices or meal frequency.