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Irritable Bowel Syndrome

  1. What is it?
  2. Causes
  3. Symptoms
  4. Diagnostics
  5. Treating
  6. Prophylaxis and prognosis

Irritable Bowel Syndrome

This is a functional disorder, accompanied by stomachache. There are no structural disorders in the intestinal wall. The average age of patients is 20 - 40 years, and women suffer from this pathology almost 2 times often.

What is it?

Irritable bowel syndrome (IBS) is pain, which:

  • either weakens after defecation;
  • or is combined with defecation frequency changing;
  • or is combined with a liquid stool or constipation.

Therefore, ICD disease codes (K 58) include IBS with diarrhea (K58.0) and without diarrhea (K58.9). The pathology frequency occurrence worldwide reaches 23%. About 1% of the population suffer from irritable bowel syndrome every year.

Not every abdominal pain associated with defecation disturbed is considered as this pathology revealed. The sick person should track discomfort for at least six months, and the relationship "abdominal pain - stool - no pain" should being noticed for at least three days monthly for at least the last 3 months.

Over two-thirds of patients suffering from the disease do not call for medical help and try to challenge on their own. That can lead not only to the belated diagnosis of chronic intestinal disease, but also to decline in the quality of life against the background of untreated IBS.

Causes

The direct reasons for developing pathology are unknown. However, there are risk factors increasing likelihood of the disease:

  • 20 - 39 years age;
  • female sex, women usually get IBS with diarrhea, while men feature constipation; in case of long course of the disease, the lesion frequency in women and men aged 50 and elder gets the same;
  • suffering from poor-quality food;
  • beside living close relatives suffering from the same disease increases the likelihood of starting IBS by 3 times;
  • stress, anxiety, depressive conditions, mental trauma;
  • suffering from violence, including "domestic" one;
  • suffering from gastroenteritis.

Symptoms

In people under 45 years of age with no reason to suspect serious bowel diseases, for example, malignant tumors, the diagnosis is made only on the basis of symptoms. In addition to abdominal pain associated with changes in stool, constipation or diarrhea frequency, other symptoms of IBS occur:

  • bloating;
  • excreting less than 3 times a week or more than 3 times a day;
  • need for strain;
  • urgent need for defecation;
  • feeling of incomplete emptying of the intestinal tract;
  • slime presenting on stool excreting from the rectum;
  • increased symptoms after stress or having meal;
  • anxiety, depression.

Patients face long course of the disease and examination while the overall health state is satisfactory. They complaint a lot. The quality of person`s life suffers from the working and sleeping modes disturbed and worrying about his/her health.

Often, these patients feature accompanying symptoms burdening IBS:

  • fibromyalgia, a disease of an unclear nature, accompanied by a common permanent muscle pain;
  • chronic fatigue syndrome;
  • arthrosis of the temporomandibular joint;
  • prolonged pain in the pelvic area.

Syndrome of irritable bowel is rarely registered in children. More often, at this age they face common functional dyspepsia, celiac disease, lactase deficiency, intestine anatomical structure anomalies.

Diagnostics

On one hand, irritable bowel syndrome occurs in young people having no signs of digestive system diseases. On other hand, it is the exceptional diagnosis anyway. Therefore, depending on the specific situation, the set of diagnostic researches may include some of the following tests:

  • blood test with determing ESR and PSA level;
  • anti-endomisial antibodies (connective tissue of smooth intestine muscles);
  • Ultrasound of the abdominal cavity;
  • analysis of feces for hidden blood, worm eggs and other parasites;
  • a test for lactose intolerance (in a child).

Colonoscopy is implemented in all over 50-years old patients and in younger patients having concomitant anxiety. Also, an in-depth examination of the colon is prescribed for elderly people whose complaints have been registered recently, as well as in seminal cases of intestinal cancer.

With prolonged diarrhea, a complex examination is often necessary, including:

  • determination of cyanocobalamin, ferritin, folic acid, albumin, calcium levels concentrated in blood;
  • researching TSH and thyroid hormones;
  • microscopic stool examination;
  • biopsy of the rectum wall;
  • X-ray examination of the intestine with barium contrast and colonoscopy to exclude colitis.

Treating

Successful treating primarily depends on how proper the sick person complies with the doctor's recommendations.

All patients are recommended diet:

  • having slow regular meal, without watching TV or working in parallel;
  • having meal 5 - 6 times a day without long breaks;
  • limit smoking, refuse to drink alcohol and soda;
  • when bloating, take soluble tissues (porridge), when having constipation – cell tissue and bran;
  • when having liquid stool, "Filtrum" is prescribed, as it binds gases and liquid, limiting suction of intestine irritators, like fresh vegetables and fruits;
  • when having flatulence, limit eating animal fats, cabbage, milk, baking.

Important: Before applying, read the instructions or consult your doctor.

To achieve better and faster treatment, keep food diary to reveal foods increasing intestinal distress.

IBS patients should work out in moderate mode (fast walking, swimming) for 30 minutes a day. A small rest is desirable.

The treating protocol include the following medicines:

  • antispasmodics;
  • antidiarrhoeic drugs;
  • laxatives;
  • combined medicines;
  • probiotics;
  • antidepressants;
  • drugs depressing vomiting center activity in the brain;
  • some antimigraine drugs influencing metabolism in nervous tissue;
  • drugs enhancing producing intestinal juices and stimulating moving stool.

Psychotherapy helps patients well.

Prophylaxis and prognosis

Prevention of developing irritable bowel syndrome is based on eliminating risk factors. So, prevention of digestive disorders includes the following measures:

  • drink more water (up to 1.8 - 2 liters per day);
  • eat products containing live microorganisms beneficial for the intestine (probiotics), as well as prebiotics developing healthy environment for these microbes;
  • limit having gas-generating food (cabbage, brown bread, grapes, soda);
  • eat less fat;
  • refrain from drinking caffeine, alcohol or cola;
  • refrain from overeating, distribute having meal more evenly throughout the day;
  • chew slowly;
  • exclude sorbitol and fructose;
  • avoid stressful situations

Despite the ongoing therapy, most patients still have the pathology symptoms, but the intensity does not stretch this thing out. The probability of their disappearance within 1 to 2 years is only 38%.

Factors lowering the gastric discomfort to disappear:

  • runny stool predominance;
  • unwillingness or inability to full-packed treating;
  • fear of serious bowel diseases;
  • long-term disease;
  • significant influence of pathology on the patient's daily activity;
  • constant stress;
  • mental abnormality;
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