Irritable Bowel Syndrome - Causes, Symptoms and Treatment. MF.

Irritable bowel syndrome( IBS) is an intestinal disease that manifests itself in abdominal pain in combination with abnormal bowel function. Approximately 20% of the population suffers from this disease. The syndrome is most common in the age group 30-40 years. But, unfortunately, more than half of the ill do not seek medical help, considering the manifestations of irritable bowel syndrome as a sign of malnutrition or an individual physiological feature.

Causes of irritable bowel syndrome

It is currently believed that the main cause of the disease is stress. Overexertion, negative emotions, especially if they are experienced inside, lead to an overexcitement of the nervous system. In this case, the inner shell of the intestine becomes very sensitive to various effects. Therefore, even minor errors in the usual diet or the use of "new" products, in conditions of psychoemotional overstrain can cause IBS.With an increase in the activity of the nervous system, intestinal motility is disrupted, which explains the occurrence of diarrhea and constipation in this disease, and irritation of the inner shell of the intestine with various stimuli contributes to the development of pain in the abdomen.

Possible Symptoms of Irritable Bowel Syndrome

In 1990, certain signs of the disease were identified in Rome, in the identification of which the diagnosis of irritable bowel syndrome may be considered the most reliable. So, irritable bowel syndrome is likely if for at least 12 weeks a year( not necessarily in a row) you are concerned:

• pain or discomfort in the abdomen. Many patients note the different nature of pain: aching, pulling, compressive, cramping, cutting. The pains vary in intensity: from light, hardly palpable, to intolerable. They occur in different areas of the abdomen, often in several places at the same time. A special feature of the pain syndrome is the absence of any sensations at night, although after awakening the pain may appear immediately. As a rule, abdominal pain occurs after eating, especially abundant, and decreases or completely disappears after defecation( bowel evacuation through the anus).With severe soreness, irritable bowel syndrome is diagnosed with a predominance of pain syndrome.

• Bloating. As a rule, bloating accrues during the day, reaching a maximum in the evening, occurs or intensifies after eating. After defecation usually disappears.

• Stool disorder. Depending on the nature of the disorder of the stool, irritable bowel syndrome is distinguished, with predominance of diarrhea, constipation, or a mixed variant.

With diarrhea, stools usually occur in the morning, often after meals. Frequency of stool 5-6 times a day. Fecal masses are liquid, watery. Quite often, sharp and painful desires for defecation arise at the time of psychoemotional overstrain( examination, an important meeting) or in places where the emptying of the intestine is impossible( in the metro, at the cinema).Therefore, the patient deliberately refuses from cultural events, long trips, which significantly reduces his quality of life. Such desires never occur at night, which distinguishes irritable bowel syndrome from other diseases. After a bowel movement there is a feeling of incomplete emptying of the intestine.

Constipation of is a rare( less than 3 times a week) emptying of the intestine. In case of constipation, the stool consists of small dense lumps, or it is "corky", when the first portion of feces is hard, separated with difficulty, the rest has a normal consistency. For the act of defecation, you need a long, often painful strain. In fecal masses, as with constipation, and with diarrhea, mucus is often found.

Diagnosis of irritable bowel syndrome

Irritable bowel syndrome refers to so-called functional diseases. This means that the substrate of the disease can not be detected, and the diagnosis is made on the basis of clinical manifestations. But, often, the above symptoms occur in other, more serious diseases of the gastrointestinal tract. Therefore, a full comprehensive survey is relevant.

If you have abdominal pain, stools and flatulence, it is recommended that you consult a gastroenterologist. Most likely, the following diagnostic tests will be assigned:

• general blood test. Detects anemia as a manifestation of latent bleeding and an increase in the number of white blood cells, which indicates the presence of inflammation.
• Biochemical blood test. For example, increasing the concentration of amylase suggests inflammation of the pancreas-pancreatitis, which explains the diarrhea.
• Fecal occult blood test helps detect bleeding that is not visible to the eye, and increased fat loss with feces suggests the presence of pancreatitis.
• Coprological and microscopic study of stool will reveal the main disease, including the infectious process.
• Ultrasound of the abdominal cavity is the gold standard for the detection of pancreatitis, cholecystitis, neoplasms of internal organs.
• Colonoscopy - instrumental examination of the intestine. Helps in the diagnosis of inflammatory diseases, developmental anomalies, tumors, diverticulums( protrusion) of the intestine.

In the absence of abnormalities, the diagnosis of irritable bowel syndrome is made.

Treatment of irritable bowel syndrome

Features of nutrition and lifestyle in the treatment of irritable bowel syndrome

Food correction plays a huge role in the treatment of the disease. The peculiarity of irritable bowel syndrome is the fact that in different patients symptoms can cause different products. Therefore, it is advisable to maintain a food diary, where to indicate the product and the reaction of the body after its use. This will identify the provoker product and, if possible, exclude it from the diet.

Foods containing food fibers should predominate in food. Preference is given to various cereals( buckwheat, oatmeal, rice).If necessary, additionally it is recommended to use biological active additives with food fibers. Take food 5-6 times a day in small portions. Depending on the prevailing symptom, the following features of the diet are distinguished:

• When inflating the stomach, products that stimulate gas formation are prohibited: beans, cabbage, milk, potatoes, fatty meats and carbonated drinks. Recommended lactic-acid foods, enriched with prebiotics( kefir, yogurt).
Quite a common cause of IBS is dysbiosis, so in addition to diets and spasmolytic drugs use means that normalize the work of the intestine. Treatment of meteorism in IBS should work in two directions: first, it is necessary to eliminate the symptoms of bloating, and, secondly, to restore and maintain the balance of the intestinal microflora. Among the tools that have at once two of these actions, the Redugas stand out. Simethicone - one of the components contained in the composition, fights with discomfort in the abdomen and delicately releases the intestine from the gas bubbles, weakening their surface tension throughout the intestine. The second component of the prebiotic Inulin helps to avoid the re-formation of gases and restores the balance of beneficial bacteria necessary for normal digestion. Inulin inhibits the growth of bacteria that cause gas formation, so a second swelling does not occur. Also from the pluses it can be noted that the product is available in a convenient form in the form of chewing tablets and has a pleasant mint flavor.
• With diarrhea appointed different jelly, strong tea, a decoction of blueberries, rusks, low-fat meat broths, cereals from cereals on the water.
• For constipation, prunes, well-cooked vegetables, vegetable oil, puree from fruit and vegetables, as well as increased consumption of beverages, including juices with pulp are recommended.

Patients with irritable bowel syndrome are required regular physical activity. This has a beneficial effect on the nervous system, contributes to improving the body's resistance to stress and getting rid of depression.

Psychotherapy as a treatment for irritable bowel syndrome

Given the fundamental role of the stress factor in the onset of the disease, psychotherapeutic interventions can, if not cure the patient, significantly reduce the manifestations of irritable bowel syndrome. Many patients with irritable bowel syndrome are advised by a psychotherapist. Psychotherapeutic methods of treatment, including hypnosis techniques, allow to reduce anxiety level, learn to resist stressful actions, adequately react to problem situations. In some cases, patients with the syndrome may be prescribed antidepressants( amitriptyline).Applying them even in minimal doses makes it possible to achieve a significant improvement in well-being.

Drug-induced treatment of irritable bowel syndrome

Drug therapy for a syndrome is usually symptomatic and is directed primarily at treating a predominant symptom.

• For severe pain and bloating, the use of analgesics( analgin), as well as remedies for relaxing bowel muscles( dicyclomine) is recommended. Currently, short courses of treatment with these drugs are recommended. In addition, when bloating is used espumizan-drug, reducing gas formation.
• With diarrhea, fixing agents( loperamide) are shown.
• For constipation, laxative preparations are used - Dufalac.
• Irritable bowel syndrome is often accompanied by intestinal dysbacteriosis. In this case, drugs containing beneficial bacteria such as bifiform may be recommended.

Possible complications of irritable bowel syndrome

Irritable bowel syndrome, even with prolonged course, does not lead to the formation of tumors and does not predispose to the occurrence of other intestinal diseases. The prognosis for the syndrome is favorable, the disease is successfully treatable, it is possible to completely cure.

Prevention of irritable bowel syndrome

• Regular psychological training and auto-training aimed at reducing susceptibility to stress.
• Correct power mode. It is necessary to take food 4-5 times a day, limiting fatty and caffeine-containing foods. Recommended use of foods rich in dietary fiber, as well as lactic-acid foods with prebiotics.
• Regular dosed physical activity.
• Refusal from unreasonable use of drugs for the treatment of diarrhea, constipation.

Doctor therapist Sirotkina EV