الثلاثاء، 7 يونيو 2011

IBS - Irritable Bowel Syndrome


Overview, Causes, & Risk Factors

Irritable bowel syndrome, or IBS, is a condition characterized by abdominal cramping, bloating, gas, and other changes in the bowels.
What is going on in the body?
Normally when a person eats, the stimulation of the food causes the muscles of the colon to contract. This contraction then pushes the stool toward the rectum to the outside of the body. IBS seems to cause the colon to be more sensitive to stimulation.
What are the causes and risks of the condition?
It is not clear what causes IBS. Emotional stress and diet, especially one high in calories and fat, seem to be some of the factors that increase the symptoms associated with IBS. Other factors include:
  • hormonal changes, especially in females during menstruation

  • conditions affecting the nerves that control digestion

  • changes in physical activity level

    • Symptoms & Signs

    What are the signs and symptoms of the condition?
    Symptoms of irritable bowel syndrome may include:
  • abdominal distress that is often relieved with a bowel movement

  • bloating, or feeling like the stomach is inflated

  • excess gas

  • changes in stool. Some people with IBS may have painful, loose stools, or diarrhea, while others may have painful hard stools, or constipation. Some people may alternate between diarrhea and constipation.

  • the sensation that there is still more stool in the bowel immediately following a bowel movement

  • mucus in the stool

  • anxiety, frustration, or depression

  • nausea

  • headache

  • fatigue

  • chest pain

  • heartburn

    • Diagnosis & Tests

    How is the condition diagnosed?
    To diagnose IBS, a healthcare provider often starts by ruling out other possible causes for the symptoms. After a complete history and physical, the healthcare provider may order:
  • an ultrasound of the abdomen

  • a barium enema

  • a colonoscopy, a procedure in which a tube with a camera on the end is used to look at the intestines

  • a complete blood count, or CBC, to check for infection

  • stool tests and cultures to look for blood in the stool, infection, or parasites

  • a biopsy of any fluid or growths to rule out infection, tumor, or cancer

    • Prevention & Expectations

    What can be done to prevent the condition?
    Since the cause of irritable bowel syndrome is not clear, it may be difficult to prevent. The following steps may help:
  • watching caloric intake

  • eating a diet low in fat

  • avoiding gas-producing foods, caffeine, and alcohol

  • monitoring fiber intake

  • reducing stress and learning stress management techniques


    • What are the long-term effects of the condition?
    Irritable bowel syndrome does not appear to damage the stomach or intestines. The long-term effects are often associated with stress and frustration over the symptoms.
    What are the risks to others?
    Irritable bowel syndrome is not contagious and poses no risk to others.

    Treatment & Monitoring

    What are the treatments for the condition?
    Treatment of irritable bowel syndrome often focuses on treating the symptoms and preventing flare-ups. This may include:
  • a diet low in fat and calories, and high in fiber. Eating several smaller meals during the day rather than large meals, particularly in the evening, may also decrease the symptoms.

  • antidepressants to decrease the pain as well as the stress and depression

  • stress management

  • fiber supplements or laxatives for constipation

  • medications to stop diarrhea

  • medications to decrease nerve sensitivity in the bowels

  • antispasmodic medications to relieve bowel spasms

  • behavioral therapy


    • What are the side effects of the treatments?
    Antidepressants may cause diarrhea, sleep disorders, headaches, irritability, and decreased libido.
    What happens after treatment for the condition?
    Symptoms of irritable bowel syndrome can and often do reoccur. A person with IBS needs to continue dietary management for the rest of his or her life. Antidepressants may not be needed after stress management or behavioral therapy helps a person gain control over emotions.
    How is the condition monitored?
    Any new or worsening symptoms should be reported to the healthcare provider.

    Attribution

    Author:Eileen McLaughlin, RN, BSN
    Date Written:
    Editor:Ballenberg, Sally, BS
    Edit Date:11/29/00
    Reviewer:Melissa Sanders, PharmD
    Date Reviewed:07/05/01
    Sources
    www.niddk.nih.gov/health/digest/pubs/irrbowel/irrbowel.htm
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