Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, which interferes with the normal function of the large intestine, characterized by abdominal pain of discomfort, bloating and altered bowel habit.
“Irritable bowel” refers to a disturbance in the regulation of bowel function that results in unusual sensitivity and muscle activity.
“Syndrome” refers to a number of symptoms and not one symptom exclusively.

1/5 people has IBS, making in one of the most common disorders diagnosed by doctors. It occurs more often in women than in men, and it usually begins around age 20.

What causes IBS?
We do not know what exactly causes IBS. Symptoms cannot be traced to a single organic cause. Research suggests that people with IBS seem to have a colon that is more sensitive and reactive than usual to a variety to things, including certain foods and stress. Some evidence indicates that the immune system, which fights infection, is also involved. Research has shown that celiac disease is present in a smaller group of people with symptoms of IBS.

IBS is not caused by stress. It is not a psychological or psychiatric disorder. Because of the connection between the brain and the gut, symptoms in some individuals can be exacerbated or triggered by stress. Dietary and hormonal factors can affect symptoms of IBS.
IBS is not an indication of another more serious disease, like cancer.

IBS classification

a) IBS-C = IBS with constipation (the most common, 34%)
b) IBS-D = IBS with diarrhoea
c) IBS-A = IBS with alternating bowel function

Diagnosis
There are no physical findings or diagnostic tests that confirm the diagnosis of IBS. Extensive testing may be reserved for specific situations.
According to the Rome II consensus conference on functional bowel disorders, the diagnosis of IBS can be made when the following criteria are fulfilled:

• Abdominal pain or discomfort for at least 12 weeks out of the previous 12 months. These 12 weeks do not have to be consecutive. 
• Abdominal discomfort or pain that has 2 of 3 features: 
  • It is relieved by having a bowel movement 
  • A change in how often you have a bowel movement 
  • A change in the form of the stool or the way it looks.

The diagnosis of a functional bowel disorder always presumes the absence of a structural or biochemical explanation for thy symptoms. This has to be excluded carefully via: 

• Colonoscopy 
• Esophagogastroduodenoscopy (EGD) 
• Abdominal ultrasound 
• Blood tests 
• Stool chemistry 
• H2-tests

Treatment
No cure has been found for IBS, but many options are available to treat the symptoms.
Patients with mild IBS symptoms are usually treated by primary care practitioners, rather than specialists. Treatment is directed toward education, reassurance, achievement of a healthier lifestyle, and occasional medication.
Pharmacologic therapy is best used in IBS patients with moderate to severe symptoms refractory to physician counselling and dietary manipulations.
The treatment of IBS is based on a working partnership between patient and the doctor.