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Irritable bowel

Though in gastroenterology, irritable bowel syndrome has been defined as a functional bowel disorder; a significant question remains unanswered – whether the irritation refers to the affected person or is it experienced by the medicine man who gets vexed by being unable to diagnose the disease. The irritation on part of the former is nevertheless, understandable – he/she has to rush to the toilet in the middle of a session at 2 in the afternoon which under normal circumstances would have been considered preposterous and most inappropriate, and yet it becomes a ‘must’ to save the situation. Another issue is equally relevant with IBS (irritable bowel syndrome) and that relates to its ‘discovery’. Abdominal pain, bloating, constipation, diarrhea, occasional blood stool, etc accompanies many other human disease conditions that seldom becomes ‘irritable’, whereas, IBS seems to have a self-appointed displeasure attached to it.

However, there seems to be some fine line of demarcation between diarrhea in a normal person and the same with a person with IBS. One affected with IBS may have a loose motion for a couple of days and then suddenly develop constipation for the next couple of weeks. Also bizarre are the abdominal pain pattern that accompanies IBS. It appears to shift from one abdominal region to another as the disease (or its manifestation) progresses. It is probably the unpredictability of the uneasiness that defines IBS best.

Also, as the disease has not yet been fully defined, its cure obviously has not been in sight. However, several chronic conditions are often linked with IBS like celiac disease, parasitic infections like amoeboid contamination or giardiasis, cholangitis, cholecystis, inflammatory bowel diseases, functional chronic constipation and chronic functional abdominal pain. In IBS, routine clinical tests yield no abnormalities, though the bowels may be more sensitive to certain stimuli, such as balloon insufflation testing. The exact cause of IBS is unknown. The most common theory is that IBS is a disorder of the interaction between the brain and the gastrointestinal tract, although there may also be abnormalities in the gut flora or the immune system.

Apart from having gastroesophageal reflux, the primary symptoms of IBS include abdominal discomfort, sudden impulse to visit the toilet with a feeling of incomplete evacuation (tenesmus), abrupt change in bowel movement, bloating or abdominal distention and a host of pseudo-imaginary stomach ailments. People with IBS also often complain about symptoms relating to genitourinary system, fibromylagia, backache and headache. IBS may also take the form of diarrhea-predominant (IBS-D), constipation-predominant (IBS-C) or alternative type, i.e. (IBS-A). Those who have developed IBS after suffering from some infective disease conditions are often branded under post-infective syndrome or simply IBS-PI.

As there is neither any pathological testing system that can identify IBS or any imaging procedure to pin point IBS, the only method of diagnosing IBS stems from negative approach. In other words, diagnosis of IBS involves excluding conditions that can manifest IBS-like symptoms and then taking up procedures to identify IBS. However, since there are quite a good many causes of diarrhea and IBS-like symptoms, the American Gastroenterological Association has published a set of guidelines for tests to be performed to diagnose other conditions that may have symptoms similar to IBS. While these include lactose intolerance, gastrointestinal infections and coeliac disease, practical experience proves that the guidelines are seldom followed. What happens instead consist of practicing various diagnostic algorithms. Some of the superior algorithms include Rome I Criteria, Rome II Process and Manning Criteria. Incidentally, the controversial Rome III Process has been published about a couple of years ago, which, unfortunately, has not been able to throw enough light on IBS or its probable cure.

One of the most significant points about IBS is that it is a so-called functional disorder, suggesting that it does not have any underlying structural cause. And this may differentiate it from two other chronic digestive diseases that are caused by inflammation, namely, Crohn’s disease and Ulcerative colitis, commonly known as Inflammatory Bowel Disease or IBD. Chances are that people often tend to mix up IBS and IBD though quite different in nature.

Since there is no ethical treatment of IBS, doctors often prescribe peppermint oil which acts as antispasmodic in the intestinal tract. Although peppermint tea is widely used to aid digestive troubles, if you’re treating IBS it’s probably better to take a standardized dosage on a consistent basis. For this you’ll probably want to get capsules and the best of these are enteric-coated, meaning that they have a special covering that prevents breakdown in the stomach, which can cause heartburn, and allows for passage down through the intestines for proper absorption. Also significant is the consumption of soluble fibers that include oats, legumes (beans, peas, lentils), fruits and berries. However, trial and error method perhaps suits the condition best.
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