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Irritable Bowel Syndrome
(IBS)
Irritable bowel syndrome is a condition that is
characterized by either constipation or diarrhea, together with, bloating, pain
and discomfort. Although it does not cause lasting damage to the intestinal
tract, this does not minimize the impact of IBS since sufferers are often
severely affected by this condition. A majority of Americans suffer from IBS,
enough to account for one in four visits to a physician. The unpredictability
of the condition often makes sufferers unable to work or engage in social
activities.
The exact
causes of IBS are, as yet unknown, although it
is thought that sufferers are more susceptible to certain triggers such as
cigarette smoking, alcohol, chocolate and stress than other people. Women suffer
from IBS more often than men and sufferers report that symptoms usually worsen
during the part of their menstrual cycles just prior to their periods, so a
hormonal element has been implicated. The bowel is lined with muscles that
alternately contract and relax to move intestinal contents through the colon, a
process called peristalsis. However in people with IBS, these contractions are
either speeded up, resulting in diarrhea, or slowed down, with the end result of
constipation.
First and
foremost in controlling this condition is prevention, which centers on avoiding
the food and beverage triggers. He first step is to keep a diary that records
the dates of attacks and the foods eaten, together with the other conditions
surrounding it. Many physicians recommend meditation, behaviour feedback and
other methods for their patients' stress.
For those who suffer symptoms of constipation, fiber supplementation has been
shown to be effective. For patients with severe symptoms, or with symptoms that
do not respond to these therapies, physicians may recommend drug therapy for
treatment of pain, for example, low-dose antidepressants which act as pain
relievers and are also effective against stress.
Antispasmodic medicines, (Bemote, Bentyl, Di-Spaz) and hyoscyamine (Levsin,
Levbid, NuLev), may be prescribed to counteract the symptoms diarrhea associated
with irritable bowel syndrome. These medicines slow the action of the digestive
tract and reduce the occurrence of spasms. However, they can have side effects.
Several other anti-diarrheal medicines such as Imodium, Kaopectate, and Lomotil,
can be effective against this symptom, but are not for long-term use.
Patients who do not improve with these recommended treatments are sometimes
treated with two newer drugs, which are both advocated for short-term use only.
For women who are primarily bothered by symptoms of constipation, Tegaserod or
Zelnorm can be prescribed to stimulate the GI tract. This treatment is
terminated if symptoms worsen or if diarrhea occurs. The second of these drugs,
which have only been FDA approved for use in women, is Alosetronor or Lotronex,
which is a treatment for severe, chronic, diarrhea-predominant IBS. This is
used only in extreme cases since severe, sometimes fatal, gastrointestinal side
effects have occurred in association with its use.
Prevention of IBS, as with many conditions is most effectively treated by
prevention. In this case, stress reduction coupled with identification and
eradication from the diet of food "triggers" remain the keys to controlling this
unpleasant and debilitating syndrome.
IBS |
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