Living with Irritable Bowel Syndrome
A common disorder of the gut that comes and goes, Irritable Bowel Syndrome or IBS is uncomfortable, distressing and sometimes even disabling though hardly ever serious - at least in the physical sense.
Causing lasting abdominal pain and abnormal bowel movements that unavoidably impair quality of life over the long-term, the condition tends to wane over time and does not lead to serious diseases of the colon or reduce the lifespan of the sufferer.
Affecting up to 20 per cent of people in western countries, IBS can occur at any age but is more common in adults below 45 years of age and usually affects women more than men. The cause is not known though it is believed that an excessive or insufficient activity of either the muscles and/or the nerves found within the inner lining of the colon is the underlying abnormality.
The frequency and severity of the illness vary greatly from person to person. The main symptoms include persistent abdominal pain and spasms with bloating and excessive production of gas that occur at least 3 days per month and for at least 3 months. Modifications of bowel movements consist of recurrent and/or alternating episodes of diarrhoea and/or constipation, often |associated with the need to urgently pass the stool. Discomfort |in the abdomen is usually relieved after defecation. Stools may contain mucus but not blood.
The condition is often triggered by some foods or beverages (especially spices, alcohol, soda and chocolate), a food intolerance (lactose, gluten), a bacterial or parasitic infection of the gut, |some hormonal changes (in women IBS is more common around menstruation) and stress.
There is no specific test to confirm IBS, so it is usually diagnosed on recognised symptoms once other chronic and more severe illnesses of the colon such as inflammatory disease (Crohn’s disease, ulcerative colitis) or colon cancer have been ruled out. These are suspected if other symptoms or signs such as weight loss, fatigue, anaemia (low haemoglobin and red blood cells level) and blood in the stool are also present. Where there is any doubt, blood and stool tests, imaging investigations and exam of the colon internal lining (colonoscopy) may be needed. People with chronic abdominal pain suggestive of IBS should consult a gastro-enterologist |(an internal medicine specialist who treats disorders of the |gastrointestinal tract) for thorough evaluation and treatment of the condition.
Left untreated IBS frequently affects the patient’s quality of life and may subsequently lead to mental disorders including depression. Despite the long-term evolution of the syndrome, the severity and duration of the recurrences often diminish over time and with proper management, the overall condition can significantly be improved.
While there is no cure for IBS, various therapeutic approaches are effective in alleviating most of the symptoms of flare-ups. These include:
l Lifestyle modifications: eating an appropriate diet that eliminates all potential foods or beverage triggers (in particular alcohol, soda, caffeinated drinks and intolerant nutrients); regular exercise; the absorption of at least 2 litres of water per day; and controlling any stressors prone to negatively impact the colon function.
l Medicines to minimise either diarrhoea (loperamide) or constipation (mild laxatives) episodes, to reduce abdominal spasms (antispasmodics) or bloating (peppermint oil), to treat a colon infection (antibiotics or antiparasitics), and sometimes to modulate and improve the intestine movements with psychotropic |medications (anxiolytics or antidepressants). There are 2 medicines indicated for IBS but they are used only in women and under certain conditions.
l Alternative therapies could also be proposed with probiotics (nutritional supplements containing good bacteria for the colon), meditation and, when previous approaches have been ineffective, psychological support with an experienced therapist, such as Cognitive Behavioural Therapy (CBT), hypnotherapy and |counselling.
DR GERARD LALANDE is managing director of CEO-Health, |which provides medical referrals for expatriates and customised executive medical check-ups in Thailand. He can be contacted at [email protected],
