Irritable bowel syndrome is a condition that is characterized by either constipation or diarrhea, together with bloating, pain, and discomfort. Although it does not cause lasting damage to the intestinal tract, this does not minimize the impact of IBS since sufferers are often severely affected by this condition.
A majority of Americans suffer from IBS, enough to account for one in four visits to a physician. The unpredictability of the condition often makes sufferers unable to work or engage in social activities.
Causes of IBS
The exact causes of IBS are as yet unknown. However, it is thought that sufferers are more susceptible to specific triggers such as cigarette smoking, alcohol, chocolate, and stress than other people. Women suffer from IBS more often than men, and sufferers report that symptoms usually worsen during the part of their menstrual cycles just before their periods, so a hormonal element has been implicated.
The bowel is lined with muscles that alternately contract and relax to move intestinal contents through the colon, a process called peristalsis. However, in people with IBS, these contractions are either sped up, resulting in diarrhea, or slowed down, with the result of constipation.
First and foremost in controlling this condition is prevention, which centers on avoiding the food and beverage triggers. The first step is to keep a diary that records the dates of attacks and the foods eaten, together with the other conditions surrounding it.
Many physicians recommend meditation, behavior feedback, and other methods for their patients’ stress. For those who suffer symptoms of constipation, fiber supplementation is effective. For patients with severe symptoms or with symptoms that do not respond to these therapies, physicians may recommend drug therapy for the treatment of pain, for example, low-dose antidepressants that act as pain relievers and are also effective against stress.
Antispasmodic medicines, (Bemote, Bentyl, Di-Spaz) and hyoscyamine (Levsin, Levbid, NuLev), may be prescribed to counteract the symptoms diarrhea associated with irritable bowel syndrome.
These medicines slow the action of the digestive tract and reduce the occurrence of spasms. However, they can have side effects. Several other anti-diarrheal medications such as Imodium, Kaopectate, and Lomotil, can be effective against this symptom but are not for long-term use.
Patients who do not improve with these recommended treatments are sometimes treated with two newer drugs, which are both advocated for short-term use only. For women who are primarily bothered by symptoms of constipation, Tegaserod, or Zelnorm, can be prescribed to stimulate the GI tract.
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This treatment is terminated if symptoms worsen or if diarrhea occurs. The second of these drugs, which have only been FDA approved for use in women, is Alosetronor or Lotronex, which is a treatment for severe, chronic, diarrhea-predominant IBS. This is used only in extreme cases since severe, sometimes fatal, gastrointestinal side effects have occurred in association with its use.
Prevention of IBS, as with many conditions, is most effectively treated by prevention. In this case, stress reduction coupled with identification and eradication from the diet of food “triggers” remains the keys to controlling this unpleasant and debilitating syndrome.