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What is IBS and symptoms
Irritable bowel syndrome or IBS is a functional disorder affecting mainly the large intestine.
The symptoms of irritable bowel syndrome are varied from individual to individual but they do last a long time - usually for months, even years.
Some of the symptoms includes:
- Abdominal pain or cramps
- Diarrhoea or constipation or a mix of the two
- Abdominal bloatedness or distension
- Mucus in the stool
- A sense of incomplete evacuation after passing motion
Ruling out serious conditions
Before we make a diagnosis of IBS, we must make sure that symptoms are not caused by a serious medical condition like
- colorectal cancer
- inflammatory bowel disease like Crohn’s or ulcerative colitis
- diverticular disease
- or other colon infective disorders.
If you do have symptoms like
- loss of appetite and weight loss
- blood in your stool
- iron deficiency anaemia
- difficulty swallowing or pain in swallowing
- persistent abdominal pain not relieved by passing gas or bowel movement
Then please see your doctor urgently for further checks to ensure that this is not a serious medical condition.
Some of the tests that your surgeon or gastroenterologists may do to exclude all these serious conditions include :
- colonoscopy
- Ct scan or MRI scan of the intestines
- blood tests like full blood count.
Diagnosis
Once possibilities of the serious conditions are excluded, then we can start to make a diagnosis for IBS
The diagnostic criteria is based on the ROME criteria where the patient has:
Recurrent abdominal pain on average of at least 1 day per week in the last 3 months associated with two or more of the following :
- relation to defecation ( meaning pain that is relieved by defecation or pain that may be worse upon defecation )
- change in frequency of stool
- change in form and appearance of stool
Risk Factors
- Age : IBS occurs more frequently in people under 50
- Females: IBS are more common amongst females
- Family history of IBS: you have a higher risk of having IBS if you do have family history
- Psychiatric or mental conditions increases your risk of having IBS
- Stress : psychological stress can cause IBS
Causes
The exact cause of IBS is still not known.
People with IBS appear to have extra sensitive muscles and nerves in the bowel. The muscles may contract too much when you eat causing abdominal cramps.
In some cases, food may be forced through your bowel more quickly, causing diarrhoea during or shortly after meals. In other, food passes slowly through the bowl causing hard stools and constipation.
There are also cases of IBS that comes on following an intestinal infection by bacterial or virus.
Treatment
Some medications to control symptoms includes:
- Laxatives for constipation
- Anti-diarrhoea medications for diarrhoea
- Anti-spasmodics for intestinal colics
- Pain killers.
Manage stress by
- Sleeping early, getting enough sleep
- Meditation and adequate exercise to bring up your happy hormones.
- Avoid certain types of food that may trigger your symptoms like alcohol, spicy and acidic food, chocolate and caffeinated drinks like coffee and soda.
- Breaking your meals up into 4-5 small meals
- Adequate fruits and vegetables to avoid constipation.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)