Irritable Bowel Syndrome

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.mb.ca

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

Irritable bowel syndrome (IBS) is the most common form of bowel disorder, affecting about 10% of the population in Western countries. Symptoms that patients experience vary and may include abdominal pain and discomfort, bloating, cramping, and altered bowel function with either cramping or diarrhea. IBS is not life-threatening, but it definitely can be life-style altering and can reduce a patient’s quality of life.

Irritable bowel syndrome can be difficult for doctors to diagnose, because there is no one test or symptom to look for. Usually IBS is diagnosed after doctors rule out other diseases through a complete medical examination and history. IBS can be suspected if as abdominal pain or discomfort for at least 12 weeks (they don’t need to be all in a row) in the past 12 months that has two of the three following features: the pain is relieved by passing a stool, the pain is associated with a change in how often a patient passes their stool, or the pain is associated with a change to either diarrhea or constipation. Symptoms of IBS not related to the stomach include tiredness, insomnia, painful urination, and back pain. IBS sufferers are sometimes divided up into diarrhea or constipation predominant subtypes. Up to three quarters of people with IBS never seek medical attention.

The cause of IBS is not known. Research has shown that emotional conflict in stress do worsen IBS symptoms, but the same research has shown other factors also play a role. Scientists have found that the colon muscles of people with IBS are far more sensitive and reactive than normal. The colon begins to spasm after only mild simulations so to respond strongly to stimuli that would not affect most people. Hence, ordinary event such as eating cause the colon to over react. Certain foods and medicines can trigger spasms. Sometimes the spasms can delay the passage of stool which can lead to constipation, or the spasms can induce diarrhea. Frequent offenders include chocolate, dairy products, caffeine, and alcohol. Psychiatric illnesses like depression and anxiety seem to be more common in people with IBS than in the general population.

There's no standard approach to the treatment of IBS. Treatment should start with education and reassurance, life-style modifications, changing diet, and psychological assessment in some patients. Triggers (e.g.,alcohol, caffeine) should be identified and avoided. Doctors frequently recommend an increase in dietary fiber. Medications are sometimes used to help alleviate specific symptoms (e.g., anti-diarrheal agents such as loperamide in patients with diarrhea predominant IBS). Anti-spasmodic agents such as scopolamine and hyoscine (buscopan) are used to help reduce painful spasms. Relaxation therapy and anxiolytics (e.g. diazepam) have been prescribed in patients with anxiety related IBS. Depending on the patient, antidepressants have also been tried with some success. There is a newer medication tegaserod (Zelnorm) that has worked with moderate success in women with constipation predominant IBS.

For more info visit: American Gastroenterology Association at www.gastro.org/clinicalRes/brochures/ibs.html

As always if you have any questions or concerns about these or other products, ask your pharmacist.