Irritable bowel syndrome (IBS) is a common and often debilitating condition that affects the large intestine. It’s a chronic disorder characterized by a group of symptoms, including abdominal pain and changes in bowel movement patterns. Although it can significantly impact a person’s quality of life, IBS does not cause changes in bowel tissue or increase the risk of colorectal cancer (Longstreth et al., 2006)[1]. This article seeks to provide an in-depth understanding of IBS, discussing its symptoms, causes, diagnostic approaches, treatment options, and strategies for managing the condition.

Delving Into Irritable Bowel Syndrome (IBS)

IBS is a functional gastrointestinal (GI) disorder, meaning it’s a problem with the GI tract’s functioning rather than damage or inflammation (Longstreth et al., 2006)[1]. According to Drossman et al. (2011), it’s characterized by recurrent abdominal pain associated with defecation or a change in bowel habits[2]. As Mearin et al. (2016) explain, it’s crucial to note that IBS is a syndrome, not a disease, as it’s a collection of symptoms that occur together and not an identifiable disease process[3].

There are three types of IBS, depending on the predominant bowel habit: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), and mixed IBS (IBS-M) (Mearin et al., 2016)[3].

Causes and Risk Factors of IBS

The exact cause of IBS isn’t known, but several factors appear to play a role (Saito et al., 2002)[4]. These factors may include alterations in gut motility, visceral hypersensitivity, post-infectious reactivity, brain-gut interactions, and alterations in the gut microbiota (Saito et al., 2002)[4].

Symptoms of IBS

The symptoms of IBS vary but usually include abdominal pain, bloating, and either diarrhoea, constipation, or both (Spiller et al., 2007)[5]. Other symptoms can include mucus in the stool, urgent need to move the bowels, a feeling of incomplete evacuation (tenesmus), bloating, or abdominal distension (Spiller et al., 2007)[5].

Diagnosing IBS

The diagnosis of IBS is typically made based on the presence of characteristic symptoms and the exclusion of other gastrointestinal diseases (Mearin et al., 2016)[3]. The Rome IV criteria are commonly used to diagnose IBS (Drossman et al., 2016)[6]. These criteria require recurrent abdominal pain, on average, at least 1 day/week in the last 3 months, associated with two or more of the following: related to defecation, associated with a change in frequency of stool, and associated with a change in form (appearance) of stool (Drossman et al., 2016)[6].

Treatment of IBS

The treatment of IBS is focused on symptom relief. According to Brandt et al. (2009), this is often a process of trial and error, and patients may need to try multiple treatment approaches to find what works best for them[7]. Treatment options can include dietary adjustments, medication, probiotics, and psychological therapies (Brandt et al., 2009)[7].

Conclusion

IBS is a common and often distressing condition that can significantly impact a person’s quality of life. Despite this, with the correct diagnosis and tailored management strategy, many people with IBS can control their symptoms and live a healthy, fulfilling life. Understanding the condition is the first step towards effective management (Longstreth et al., 2006)[1].

References

[1] Longstreth, G. F., Thompson, W. G., Chey, W. D., Houghton, L. A., Mearin, F., & Spiller, R. C. (2006). Functional bowel disorders. Gastroenterology, 130(5), 1480-1491.

[2] Drossman, D. A. (2011). The functional gastrointestinal disorders and the Rome III process. Gastroenterology, 130(5), 1377-1390.

[3] Mearin, F., Lacy, B. E., Chang, L., Chey, W. D., Lembo, A. J., Simren, M., & Spiller, R. (2016). Bowel disorders. Gastroenterology, S0016-5085(16)00222-5.

[4] Saito, Y. A., Petersen, G. M., Larson, J. J., Atkinson, E. J., Fridley, B. L., de Andrade, M., & Locke, G. R. (2002). Familial aggregation of irritable bowel syndrome: a family case-control study. The American Journal of Gastroenterology, 97(4), 818-823.

[5] Spiller, R., Aziz, Q., Creed, F., Emmanuel, A., Houghton, L., Hungin, P., Jones, R., Kumar, D., Rubin, G., Trudgill, N., & Whorwell, P. (2007). Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut, 56(12), 1770–1798.

[6] Drossman, D. A., Hasler, W. L. (2016). Rome IV—Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology, 150(6), 1257-1261.

[7] Brandt, L. J., Chey, W. D., Foxx-Orenstein, A. E., Schiller, L. R., Schoenfeld, P. S., Spiegel, B. M., Talley, N. J., & Quigley, E. M. (2009). An evidence-based position statement on the management of irritable bowel syndrome. The American Journal of Gastroenterology, 104(S1), S1–S35.