Irritable bowel syndrome

Irritable bowel syndrome (medical term: Colon irritabile) is one of the most common disorders of the digestive tract. It is a functional bowel disorder accompanied by cramping or stabbing abdominal pain, abdominal bloating (meteorism), diarrhoea or constipation (movement disturbance of the colon and its secretion, such as intestinal mucus production), occasionally alternating.

"Functional" means that there actually exists a deviation from the normal organ function, but no change in organ structure or even a malignant disease can be detected as the cause of the discom-fort.

Irritable bowel syndrome is frequent. Half of all patients with gastrointestinal complaints suffer from irritable bowel syndrome. Women are affected twice as often as men.

If the intestines of patients with irritable bowel syndrome are examined, e.g. by colonoscopy, there are no abnormal or malignant findings.

Causes

The causes for the development of irritable bowel syndrome are not fully elucidated. This complicates diagnosis and therapy. The following factors are discussed as causes or triggers of the disease

  • Food intolerances, e.g. to sorbitol, a sweetener contained in certain fruits (e.g., pears or plums)
  • Side effects of medications that contain hidden laxatives and thus lead to diarrhoea
  • Inflammatory bowel disease (ulcerative colitis and Crohn's disease)
  • Low-fibre diet
  • Stress
  • Abnormal composition of the intestinal flora with multiplication of gas-forming bacteria
  • Emotional conflict situations

Studies have shown that the movements of the intestine are altered in irritable bowel syndrome. In healthy people, there is a characteristic, recurrent movement of the small intestine. This propagates slowly toward the colon, causing the forward movement of the chyme. In patients with irritable bowel syndrome, the intestine instead contracts only in short-lasting, rapidly successive movements. The movement of the small intestine is therefore disturbed. Psychological factors seem to play a major role in the disease, not causally, but acting to either aggravate or relieve symptoms. Thus, the symptoms increase during periods of emotional stress. On the other hand, relaxation techniques may help some patients to relieve their symptoms.

 

Symptoms

The complaints are extremely variable. In irritable bowel symptom often the following symptoms are observable

  • Abdominal pain or discomfort
  • Increased pain sensitivity of the intestine and surrounding tissues
  • Altered frequency of bowel movements (more than 3 times per day or less than 3 times per week)
  • Altered stool consistency (aqueous or very hard)
  • Altered bowel habits (need for pressing, strong urge to defecate, feeling of incomplete evacuation)
  • Mucus excretion and nausea
  • The abdomen feels bloated and hard
  • Headaches
  • Diarrhoea alternating with constipation

Often the problem does not remain limited to the intestine, but affects also the upper part of the gastrointestinal tract. Pain in the upper abdomen, eructation and nausea show that the irritable bowel syndrome is associated with an irritable stomach. The condition often increases during prolonged relaxation (e.g. on holiday) and worsens under stress. Another typical characteristic of irritable bowel syndrome is weeks of freedom from symptoms after a colonoscopy, since during the investigation strong spasms are relaxed and the bowels are stretched and loosened up. The colon cleansing preceding the examination also helps to remove substances and adverse intestinal bacteria that increase the discomfort from the inside of the bowels.

 

Therapy

To restore the natural intestinal flora it is advisable to pay attention to the following:

  • A diet rich in roughage is recommended
  • Grain products and cabbage can aggravate the inclination to meteorism
  • Dietary fibre gets the intestines going
  • The amount of fibre should be gradually increased only so that the stomach and intestines can adapt
  • Avoid foods and beverages that aggravate the symptoms
  • Coffee and milk may be the main cause in some affected persons
  • A so-called intestinal cleansing (colon hydrotherapy) can have a very beneficial effect on the symptoms
  • Exercise is important to enhance intestinal function and reduce stress
  • Heat can help relieve the symptoms (wraps, hot water bottles or heating blankets)
  • Reducing stress e.g. through relaxation exercises
  • Keep a diary to find out what is causing the discomfort
  • Drink plenty of water – no alcohol!
  • Avoid foods that cause bloating, and strong spices
  • Many small helpings rather than fewer large ones