What is Irritable Bowel Syndrome?
The Irritable bowel syndrome – IBS (commonly known as ”Irritable Bowel Syndrome’ or ”Spastic colitis”) is a very common condition, predominant in the age group of 20 to 50, with an estimated 10% of the population involved. It is a debilitating disease, all the more so since half of those suffering from it suffer from weakness and fatigue. Irritable bowel syndrome is characterized essentially by recurrent abdominal discomfort or pain, but what are the causes of the onset of this disease and what is the correct approach to best live with it?
Causes of the onset of the disease
The underlying causes of Irritable Bowel Syndrome are still unknown, as a single determinant factor is not recognizable and there is no organic cause detectable by tests (e.g. laboratory tests and magnetic resonance imaging). The causes are therefore due to a combination of physiological, psychological, hormonal and social factors. Genetic predisposition, changes in the motility of the digestive tract, viscera sensitivity, subjective perception of pain, bacterial flora and intestinal infections, food allergies and intolerances, and drug abuse and stress. The latter, an increase in stress and situations with a strong emotional impact, play an important role in the development of attacks. Also those suffering from anxiety disorders (depression and somatization disorders) are particularly prone to the onset of Irritable Bowel Syndrome, as many of the events that are stressful on a psychic level also affect this part of our body.
What are the symptoms of Irritable Bowel Syndrome?
Irritable Bowel Syndrome begins with recurrent symptomatic attacks, at irregular intervals, caused by abdominal discomfort or pain. Symptoms usually improve after evacuation, which may be of a constipated, diarrhoeal or mixed type. Abdominal pain is usually associated with changes in evacuations and stool consistency. Basically, the alarm symptoms are generally:
- onset after age 50;
- weight loss;
- rectal bleeding;
A high percentage of patients also have additional symptoms such as headache, back pain, insomnia, weakness, fibromyalgia, cystitis, chronic pelvic pain and pain in the temporomandibular joint.
Clinical evaluation, tests and diagnostic tests
The clinical evaluation is carried out according to the Rome criteria, which are symptom-based principles requiring the presence of abdominal pain for at least 1 days/week in the last 3 months with ≥ 2 of the following:
(1) pain related to defecation;
(2) pain associated with a change in the frequency of evacuations;
(3) pain associated with a change in stool texture.
Many diseases (e.g. coeliac disease, lactose intolerance, drug-induced diarrhoea, giardiasis, etc.) can be confused with irritable bowel syndrome, which is why it is essential to carry out a careful evaluation through specific examinations and diagnostic tests. The first tests requested by the specialist are usually blood tests with serological markers for coeliac disease, stool tests, lactose breath tests, palpation, rectal examination and colonoscopy. Patients with chronic diarrhoea also need the Giardia antigen test. Further investigations are carried out in case of advanced age or in the presence of disorders that may suggest additional intercurrent organic diseases.
Therapy: how to live with irritable bowel syndrome
Since (in most cases) the underlying cause is unknown, the treatment strategy for irritable bowel syndrome is primarily based on the treatment of the symptoms reported by the patient. The initial approach includes:
- proper food education (which foods and drinks can be useful or harmful, which foods can create gas and abdominal distension, and which help the intestine in cases of diarrhoea or constipation);
- proper hydration;
- appropriate physical activity;
- drug therapy aimed at the dominant symptoms (laxative or antidiarrheal drugs, antispastics);
- anxiolytic drugs in the case of a patient accompanied by an anxious or depressive state.
Non-conventional therapies, such as relaxation techniques, cognitive-behavioural therapy and acupuncture, may also be recommended. These treatments are proven to be effective therapeutic tools aimed at restoring a balance of the brain-intestine axis.
The contents of this page are for informational use only and in no case should they replace the opinion, diagnosis or treatment prescribed by your doctor. The response to the same treatment can vary from one patient to another. Always consult with your doctor about any diagnosis and treatment information and strictly follow his instructions.