Irritable Bowel Syndrome - IBS
Irritable Bowel Syndrome, or IBS, refers to a wide spectrum of symptoms caused by gastrointestinal dysmotility (abnormal contraction of the gut). The cause is not known and treatment is directed at control of symptoms. We now know this is true disease indeed and is not “just in the head” as was thought before and patients do suffer from symptoms and need the physician’s full attention.
The main types of IBS include
- Diarrhea predominant
- Constipation predominant
- Mixed with alternating constipation and diarrhea
- Bloating predominant
- Nausea and Vomiting predominant
What are the symptoms of IBS?
The symptoms of IBS usually include chronic abdominal pain, change in bowel habits (constipation/diarrhea) and bloating.
IBS is a disease of exclusion; most patients require a work up (Blood Tests, Upper Endocopy, Colonoscopy, CT Scan etc) primarily to exclude other major GI Diseases that can be treated such as IBD, cancer, celiac disease etc).
How is IBS treated?
Since the cause is unknown treatment is directed at symptoms control. Organic diseases such as IBD, celiac disease and cancer have to be ruled out by appropriate tests.
Constipation predominant disease is treated with fiber (Metamucil, Citrucel etc), mild laxatives (MiraLax, Amitiza).
Diarrhea predominant disease is treated with bulking agents (Metamucil, Citrucel), stool firming agents (Questran) and anti-diarrheals (Loperamide, lomotil etc). Lactose intolerance may be present in this population and a trial of lactose exclusion may also help.
Bloating predominant disease may benefit from Probiotics (Align, Florestor, VSL etc). A trial of non-absorbable antibiotics may also help (Xifaxan) as may drugs such as Elavil.