Irritable Bowel Syndrome: Prevalence, Effect on Lifestyle

IBS is one of the most common disorder of digestive system producing a spectrum of symptoms such as persistent and recurring abdominal pain associated with passing of motion, change of bowel habit (diarrhoea, constipation, or alternate diarrhoea and constipation), etc. without any apparent cause. The word syndrome means a group of symptoms. IBS is a syndrome because it can cause several symptoms in addition to those mentioned, like cramping, bloating, gas, frequent urge to pass stools, sensation of incomplete evacuation etc.

IBS is the disorder of function, which means that the bowel doesn't work, as it should. If one visualizes the bowel, it appears perfectly normal without any inflammation or other structural changes. In people with IBS, the intestines squeeze too hard or not hard enough and cause food to move too quickly or too slowly through the intestines.

Through the years, IBS has been called by many names--colitis, mucous colitis, spastic colon, spastic bowel, and functional bowel disease, irritable colon, and nervous colon. Most of these terms are inaccurate and refers to understanding of diseases at that particular time frame. Colitis, for instance, means inflammation of the large intestine (colon). IBS, however, does not cause inflammation of the bowel and should not be confused with another disorders like ulcerative colitis.

Prevalence

IBS is very common condition across the globe and it is estimated that around 20% of people suffer from this condition some time during their life time. Over 40 million Americans and one third of the UK population suffer from IBS sometime in life. It is the single most common reason for which people seek gastroenterologist's opinion. The statistics state that people miss work for IBS and related disorders more than for anything else, except colds.

IBS though affect people of all ages and both the sexes; it is more common in young people; usually in late adolescence or early adulthood. The condition is almost two to three times common in females as compared to males.

Nature of condition

Almost everything about IBS is totally dependent on the individual patient. For some, IBS may arise during times of stress or crisis, and then subside once the stressful event has passed. For others, IBS strikes seemingly randomly and without warning and never completely goes away. The duration of IBS is different for everybody. The symptoms may wax and wane, being particularly severe at some times and absent at others. To sum up, this is a chronic relapsing condition.

Effect on lifestyle

IBS can be nothing more than a mild annoyance, completely debilitating, or anywhere in between. Again, it depends on the person and how he or she reacts to it and treats it. IBS can, however, be very painful and can severely affect a person's quality of life, and is second only to the common cold as a cause of absenteeism from work.

IBS and Stress

The key point is that IBS is strongly related to emotional stress and strain. Research on the psychosocial aspects of these disorders has yielded three general observations:

• Psychological stress exacerbates gastrointestinal symptoms.
• Psychological disturbances amplify illness experience and adversely affect health status.
• Having a functional GI disorder like IBS impairs the quality of one's life.

Causes of Irritable Bowel Syndrome (IBS)

The cause of IBS is not known. Doctors call it a functional disorder because there is no sign of disease such as inflammation or infection when the colon is examined.

With aggressive research done in this area over a period of time, scientists have come to the conclusion that the cause of IBS may be multifactorial, the cumulative effect of which results in the derangement of normal functioning of bowel.

The factors that can adversely affect the job of the bowel are as follows:

01 Psychological factors: Patients of IBS report of increasing symptoms during the events of stress and many patients with IBS report that their symptoms began during periods of major life stressors such as a divorce, death of a loved one, school exams, or after moving to a new job or city. About 50% patients exhibit range of emotional disturbance including anxiety, depression, and neurosis.

It is a known fact that our emotions and intestines are interwoven. The brain and the intestines are closely connected by nerve fibers that control the functioning of the intestines. It is believed that in IBS the communication between brain and gut may be impaired.

02 Sensitivity to food: Symptoms of IBS have also been known to be triggered by the ingestion of certain foods to which the individual is sensitive. Chocolate, milk products, caffeine, or large amounts of alcohol are frequent offenders. One theory states that lack of fiber in the diet can have detrimental effect. This lack of fiber causes irregular contractions of the large intestines.

03 Genetics and heredity: Some studies indicate that there are more chances of IBS running in a family. It is believed that there are some inborn tendencies of an individual that make him/her react adversely to stress or certain food and resulting in IBS.

04 Some patients develop IBS following an episode of gastroenteritis or abdominal surgeries like removal of gallbladder.

05 Researchers have also found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can increase IBS symptoms

06 Conventional medicines: Many patients of IBS report worsening of their symptoms following use of some of the conventional medicines like antibiotics, steroids, anti-inflammatory medicines etc.

Common Symptoms of Irritable Bowel Syndrome (IBS)

Although many IBS sufferers get similar symptoms, each individual with IBS has his own unique set of symptoms.

IBS presents in wide spectrum of severity. For some people it may just be an occasional mild episode or nuisance. For others, it can be a debilitating illness that causes frequent absenteeism from work.

The most common symptoms of IBS are as follows:

1. Altered bowel movements/habits:

Some people with IBS have constipation (difficult or infrequent bowel movements, hard stools); others have diarrhea (frequent loose stools, often with an urgent need to move the bowels); and some people experience both, for example several weeks of constipation followed by a few days of diarrhea. The diarrhea typically occurs immediately after a meal or when getting up in the morning. Sometimes people with IBS pass mucus with their bowel movements.

2. Abdominal pain and cramps:

The abdominal discomfort of an irritable bowel ranges from sharp, cramp to a continuous, dull ache. Common sites of pain include the lower abdomen, specifically the left lower quadrant. Meals may precipitate pain while pain is commonly relieved by defecation.

3. Gas formation, bloating, abdominal distention:

Patients frequently report increased amounts of bloating and gas and distended feeling.

4. Urgency:

Sometimes the person with IBS has a cramp and an urge to move the bowels but cannot do so.

5. Sensation of incomplete evacuation:

The patient feels like he still needs to have a bowel movement after he has already had one.(incomplete evacuation)

6. Extra-colonial symptoms:

In addition, a number of other symptoms not directly related to bowel may be present in patients with IBS. These include: nausea (with or without vomiting), feeling full after eating only a small meal, difficulty swallowing, a sensation of a lump in the throat or a closing of the throat, heartburn or acid indigestion, chest pain, sensation of urinary urgency, incomplete emptying after urinating, fatigue and generalized body ache or muscular pains, and pain during sexual intercourse.