Irritable bowel syndrome is otherwise shortly called as IBS. this condition is sometimes named as spastic colon. It is described as a functional disease always having the qualities of abdominal discomfort, may be with pain in the abdomen, bloating of stomach. in many cases, the patient does not have any organic cause and have alteration in the bowel habits and movements. The pain is relieved by bowel movements in some cases. The irritable bowel syndrome is classified as IBS-C, if the patients is having constipation, classified as IBS-D, if the patient has diarrhea and it is classified as IBS-A, if the patient has both diarrhea and constipation alternatively. Irritable bowel syndrome may appear after a forcible exertion of pressure on the mind by certain life events. It may also seem to appear after an infection. such type of irritable bowel syndrome is called as IBS-PI.
About cure:- several treatments are available to relieve pain and related symptoms. Medication, altered dietary pattern, physician advise, psychological changes, education of patient, mainly the good relationship between doctor and patients intervene, and gives good result in symptom disappearance.. however there is no treatment to cure irritable bowel syndrome.
Relationship of brain with the formation of the disease.:-a parasitic infection of abdomen, chronic constipation, chronic type of functional abdominal pain, giardiasis, malabsorption of fructose and coelic disease in some cases represent the character of Irritable bowel syndrome often and they mislead for irritable bowel syndrome. in certain cases the bowel seems to be very sensitive to certain type of stimuli and in many cases routine tests show no abnormalities. there is a common factor that increases the symptoms of irritabe bowel syndrome are the disorder of the brain in its behaviour of interaction with gastrointestinal tract. But, there are theories about the abnormalities of the immune system and gut flora. The definite and exact cause is not known till now.
The disease generally does not cause more serious condition: Irritable bowel syndrome does contributes to chronic and severe pain and it may even prevent the sufferer in going to their work. The study so far conducted and the researches carried out indicate that irritable bowel syndrome is the disease that may affect the quality of life in certain cases.
Speacial characters that determines the classification:-When the IBS individual is characteristic of having predominant diarrhea, it is classified as IBD-D. If it is mainly related with constipation, then it is called as IBS-C. The term IBS-A is used when the bowel habit alternates with constipation and diarrhea. The infections in certain cases causes fever, vomiting and the stool culture shows positive results and this type of post-infective syndrome is called as post infectious IBS.
The psychiatric symptoms intervene in irritable bowel syndrome:- It is found that about 60% of the patients encountering IBS are having depression and anxiety.
But, the primary IBS symptoms are abdominal pain, distention of the abdomen, bloating, particularly the bowel movement changes like constipation or diarrhea or constipation followed by diarrhea. Other symptoms include genitourinary symptoms, gastro esophageal reflux. they may also have backache, headache, fibromyalgia and chronic type of fatigue.
Risk factors and causes:- there are several theories have been submitted about the causes of Irritable bowel syndrome and it mainly described with gastrointestinal infection. The risk factors so far described are post-infection, young age, anxiety, fever and depression. But many theories so far published tries to connect the brain activity disorder in relation with gut. Brain-gut response stress and derailing of the brain -gut axis are some of the theories that explained the connection of brain activity with irritable bowel syndrome.
Rsearchers are doing more work on the causes of the IBS. Some researchers believe the overgrowth of the intestinal flora causes the disease. Others found that certain protozoa infection causes IBS. But they know only little things about the IBS causing protozoa and they agree that they have to study more to know the protozoa fully.
Blastocystitis a single cell organism which is the most important one that has been reported to cause Irritable bowel syndrome and it is identified as an organism that does not respond to common antiprotozoals.
Dientamoeba fragilitis is a type of single cell organism that causes IBS symptoms and it appears to respond to antibiotics.
Specific system of diagnosis:- there are no specific tests have been developed so far to identify or diagnose irritable bowel syndrome. a patient with IBS symptoms are categorized after ruling out lactose intolerance, celiac disease, overgrowth of gut bacteria and parasite infection. Colonoscopy is recommended for patients over 50 years of age.
Diagnostic algorithms:-Abnormal defecation and abdominal pain is a common feature in almost all digestive system disorder like inflammatory bowel disease, giardiasis, colon cancer and thyroid disorders and so also it is seen in irritable bowel syndrome also. a general guide line is followed to rule out other diseases like lactose intolerance, gastrointestinal infection and coeliac disease. after ruling out such disorders, a diagnostic algorithm is used for differential diagnosis. The popular algorithms are RomeI,II and III.
However, often certain diseases like helicobacter pylori, parasites and celiac diseases are mis-diagnosed for irritable bowel syndrome.
Effective management:-Antispasmodics, peppermint oil and fiber appears to be safe and effective methods of management. Diet restriction and lactose free diets seem to be more effective. a diet restricting fructose also gives more successful results.
Medication:-The medication includes laxatives in IBS-C, antidiarhheals like loperamide, codeine and opioid analogs are helpful in IBS-D.Antispasmodics like hyoscyamine and dicyclomine help in patients of IBS with cramps and diarrhea. Neurotropics like atropine and musculotropics like mebeverine are useful in treating IBS. Tricyclic antidepressants and serotonin antagonists are also effective for treating irritable bowel syndrome. Silicates and citrates of magnesium and alverines are commonly used in all types of IBS. The dopamine receptor blocker, domperidone is effective in reducing the bloating and pain in IBS.