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Irritable Bowel Syndrome

Irritable Bowel Syndrome IRRITABLE BOWEL SYNDROME Suffering in Silence Irritable bowel syndrome (IBS), is a common disorder of the intestines that affects nearly one out of five people in the United States. According to the book, Irritable Bowel Syndrome & the Mind-Body-Brain-Gut Connection by William B. Salt II, IBS is the most common functional gastrointestinal disorder. The symptoms include constipation, diarrhea or alternating bouts of both, bloating, abdominal pain and many other problems. Symptoms of irritable bowel syndrome usually begin during adolescence or early adulthood.

Altered bowel movements occur over periods of days to weeks. Occasionally, symptoms may be continuous. In a given individual, both constipation and diarrhea can occur, or either can be the recurring symptom. The course of the disease varies from patient to patient, but individually, it can follow a consistent pattern. The diarrhea of irritable bowel syndrome is usually of small volume, but frequent. Episodes commonly occur during periods of stress. The initial morning movement may be normal, but followed by successively loose bowel movements throughout the rest of the day.

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Bowel movements may be associated with extreme urgency. The diarrhea rarely awakens patients from sleep and there is usually no associated fever or rectal bleeding. The abdominal pain of irritable bowel syndrome can vary in severity from mild to severe. It is usually felt in the lower abdomen, especially on the left side. The pain may be dull, sharp, crampy or continuous. It is commonly relieved by the passage of gas or by defecation *1*. Each year, 2.6 million people seek treatment for symptoms related to functional gastrointestinal disorders, and visits to physicians total 3.5 million (Salt xiv).

The average age of onset of IBS is between 20 and 29 years of age, and IBS is prevalent throughout the world including China, the United Kingdom, Australia, New Zealand and Scandinavia (Salt xiv, xv). The public is made aware of cases of HIV, heart disease, various forms of cancer, etc., on a daily basis, yet IBS is relatively unheard of. Because of this, millions of people who suffer from IBS feel there is a stigma attached to their disease and they must suffer in silence. IBS is not a rare disease. In fact, it is the second leading cause of absenteeism in the workplace, coming in behind the common cold *2*. Unlike the common cold, however, there is no over-the-counter drug that can be picked up at the local drug store at the first sign of symptoms.

Furthermore, there are few prescription drugs that have been used to treat IBS with positive results. The first prescription drug specifically developed for diarrhea-predominant IBS, Lotronex, was released to the market in March of 2000. Glaxo Wellcome, maker of Lotronex, says the precise mechanism of action of the drug is not fully understood. However, the working hypothesis is that the experimental drug blocks the action of the neurotransmitter serotonin and 5-HT3 receptor sites in the gastrointestinal track. The thinking is that serotonin and 5-HT3 receptors play a role in increasing the sensations of pain and affecting bowel function in IBS patients. In addition, nerves that control the muscles in the gut may overreact to stimuli such as gas and the passage of food after a meal.

This may cause painful spasms and contractions and speed up or slow the passage of stool through the colon, resulting in diarrhea or constipation *3*. Lotronex has only been shown to work in women, and there is presently no medication available for men suffering from Irritable Bowel Syndrome. Lotronex works by blocking the level of serotonin in the intestinal system in order to reduce the cramping abdominal pain and discomfort, urgency and diarrhea. The first step in determining if the bowel problems in question are caused by IBS is to visit a physician for a check up. Chances are, he will refer the patient to a gastrointerologist, who will then order outpatient testing to be done at a hospital.

This battery of tests can include an upper and lower GI, a barium enema/X-ray, an EGDwhich consists of sticking a scope down the throat to look into the stomach, an ultrasound, and any other deemed necessary by the specialist. IBS will be diagnosed after it is determined that the patients organs are functioning properly and their insides are healthy, leaving no obvious cause for their symptoms. After the initial diagnosis, the doctor will share a variety of treatment options and suggestions with the patient. At this point, its important to deal with a physician that is understanding and willing to work with the patient to manage the symptoms. Since there is no one specific cure, the patient is about to begin a long journey to try to find the right balance of medication, therapy, stress relief, relaxation techniques and eating habits. Many top physicians agree that Irritable Bowel Syndrome is not a diagnosis, is a vague term, and carries little significance. A more correct name for the various GI problems that doctors associate with it should be unknown bowel disorder. IBS is a term that physicians will give to a patient if they have no idea what their problem is from.

Its purpose is to give the patient a name for their problem so the doctor can avoid using those words you’ll never hear him or her say, I don’t know. Physicians have a reputation for being more concerned with treating symptoms than finding or treating the cause, bringing suffering patients back into their office again and again *4*. Because of the common occurrence of Irritable Bowel Syndrome, and the inability of the medical profession to find a cause or cure for the disease, there is a pressing need to support more research. Unfortunately, research remains severely underfunded for functional gastrointestinal disorders. Less than 1% of digestive research funding, through the National Institutes of Health (NIH), is allocated for functional disorders *5*. The worst part for most IBS patients is not knowing why theyre suffering from this syndrome. There are many support groups on the Internet, including *6* and *7*. In addition, there are various organizations such as the International Foundation for Bowel Dysfunction, which is a nonprofit and informational research program. According to an article in Johns Hopkins Magazines April 1997 issue, there are four major procedures to follow to control IBS: eat more fiber, avoid culprit foods, medication, and reduce stress. First of all, increasing the daily dietary intake of fiber can dramatically improve bowel function. Fiber therapy is effective for both diarrhea and constipation predominant IBS sufferers because it stretches the bowel wall, actually decreasing tension in the bowel. Patients are advised to increase fiber gradually so as not to cause gas or bloating.

Doctors further recommend getting enough sleep and physical exercise in order to keep the bowel regular. Secondly, avoiding culprit foods can minimize symptoms. Fatty, fried or spicy foods are typical culprits for aggravating IBS. Some patients and physicians suggest avoiding traditionally gassy foods such as cabbage, beans, fructose, bran cereals and anything high in gluten. Milk can trigger symptoms in lactose intolerant IBS patients.

The only way to pinpoint foods is to keep a daily diary of everything eaten in a two-week time period. If a certain food seems to elicit a negative reaction in the digestive system, simply eliminate that food from the diet. Third, medication commonly prescribed for patients with IBS includes antispasmodic or anticholinergic medications. These are used to temporarily alleviate abdominal cramps. Over-the-counter antidiarrheal drugs or laxatives should be used as infrequently as possible and in small doses. Some physicians prescribe antidepressants to relieve pain and improve motility of the digestive system. The final recommendation of this article was to reduce stress.

Doctors used to view IBS as a disease that was all in the head of patients. Although many physicians realize the legitimacy of the syndrome, it has been proven that stress can aggravate symptoms by causing an anticipatory response. Many patients complain of anxiety and feeling a lack of control in certain situations, which increases the probability of experiencing problems with IBS symptoms on that particular occasion *8*. Because of the lack of response from medical doctors and failure to be taken seriously, many IBS sufferers have chosen to take a different r …


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