Irritable bowel syndrome (IBS) is a disorder of the lower intestinal tract that is primarily characterized by a series of symptoms often worsened by emotional stress. About 10-20 percent of the US population has IBS, and 1-2 percent gets it each year, yet only 10-20 percent of those with IBS seek medical care. IBS can occur at any age, but it often starts in adolescence or early adulthood and is more common in women.
Other names for IBS include nervous indigestion, intestinal neurosis, spastic colon, irritable colon, functional colitis, mucous colitis and laxative colitis. IBS should not be confused with inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn’s disease, although it shares many of the same symptoms.
There are many possible causes of IBS. In some cases it involves a problem with muscle movement in the intestine. In others there is a low tolerance for movement and stretching of the intestine. It usually does not entail a structural problem of the intestine. Potential risk factors include emotional stress, a low-fiber diet, the use of laxatives, and having had infectious diarrhea or other temporary bowel inflammation. Use of the drug Accutane has also been implicated.
Symptoms may include:
- Chronic and frequent diarrhea
- Chronic and frequent constipation
- Abdominal pain or tenderness
- Abdominal distention
- Abdominal fullness, gas, bloating
- Nausea and vomiting
- Emotional distress
- Loss of appetite
Tests usually reveal no problems and an edoscopy, or examination of the intestine with a flexible, lighted instrument, is only required in patients who develop symptoms later in life. Younger patients with persistent diarrhea, however, may require an edoscopy to rule out IBD. Patients over the age of 50 should be screened for colon cancer.
Complications can include:
- Malnutrition due to avoidance of food
IBS may be a life-long chronic condition, but symptoms can often be relieved or improved with treatment. Changes in diet such as increasing dietary fiber and avoiding caffeine may help relieve symptoms in some patients. Other possible treatments include:
- Regular exercise
- Anticholinergic medications
- Counseling (in cases of severe anxiety or depression)
- Low-dose antidepressants
- Anti-diarrheal medications
IBD is a group of inflammatory conditions of the large and, in some cases, the small intestine. The causes of IBD have not been determined. As is the case for IBS, however, the use of Accutane has been implicated as one of many potential causes.
The principal forms of IBD are Crohn’s disease and ulcerative colitis, but also include:
- Collagenous colitis
- Ischaemic colitis
- Lymphocytic colitis
- Diversion colitis
- Infective colitis
- Behçet’s syndrome
While Crohn’s disease can affect any part of the gastrointestinal tract and the entire bowel wall, ulcerative colitis is restricted to the mucosa in the colon and anus. Both conditions can present with extra-intestinal symptoms such as liver problems, skin manifestations, arthritis, and eye problems. Other symptoms include:
- Abdominal cramps and/or pain
- Bloody Stool
- Weight loss
A diagnosis is usually established by colonoscopy and biopsy of pathological lesions.
Treatment for IBD often begins with the administration of drugs with anti-inflammatory properties such as Prednisone. To keep the disease in remission, the patient is then switched to lighter drugs such as Asacol.
Although patients with IBD may suffer discomfort throughout their life and are likelier to contract colorectal cancer, the disease is rarely fatal on its own.