It may come as a surprise to you, since it’s often regarded as a trivial condition, but irritable bowel syndrome (IBS) is one of the most burdensome chronic ailments being reported by patients in the United States today.
Patients with IBS visit the doctor more frequently, use more diagnostic tests, consume more medications, miss more workdays, have lower work productivity, are hospitalized more frequently, and consume more overall direct costs than those without IBS. IBS is thought to afflict an estimated 10 to 15 percent of Americans. Although only less than half of people with IBS seek healthcare, it is a common diagnosis.
WHAT IS IBS?
Irritable bowel syndrome is a long-term (chronic) or recurrent disorder of gastrointestinal (GI) functioning where abdominal discomfort and/or change in bowel habit results from increased response of the intestines to a variety of influences like dietary factors, infection, or stress. Typically, the symptoms include intermittent abdominal pain accompanied by diarrhea, constipation, or alternating episodes of each. Other symptoms such as bloating may also be present.
HOW DOES IBS OCCUR?
While the exact cause of IBS is unknown, many experts believe it stems in part from abnormalities in gut (intestinal/bowel) motility, sensation, and secretion. These activities are regulated by the brain, and these brain-gut interactions may also be impaired.
But while most IBS patients exhibit one or more of these abnormalities, they do not explain all of the symptoms of IBS. Altered gut immune activation, intestinal permeability, and altered gut bacteria have also been identified in some IBS patients. Because a clear structural cause has not been found, some have erroneously speculated that IBS may be emotional or psychological in nature, but studies have shown that psychiatric disorders do not cause IBS. Although IBS is now a medically recognized disorder, the causes are just not seen through routine blood tests, x-rays or endoscopy; rather a diagnosis is made using well accepted diagnostic criteria.
The main symptom of IBS is abdominal pain or discomfort. In addition, the typical IBS patient will experience a change in stool frequency and/or form – diarrhea, constipation, or an alternation between these states. Other common symptoms include bloating, gas, passage of mucus, straining, urgency, or a feeling of incomplete evacuation. Patients are subdivided into IBS types, which are based on their principal stool form. These include diarrhea predominant IBS (IBS-D), constipation predominant IBS (IBS-C), and mixed IBS (IBS-M) where stool form fluctuates.
Symptoms can range from a mild nuisance to debilitating pain and bowel urgency. Imagine having symptoms similar to stomach flu on a chronic basis – abdominal pain, diarrhea, constipation, gas, or bloating that wax and wane but never permanently go away. The flare-ups are often unpredictable, and those with moderate to severe symptoms may find themselves planning their lives around where the next bathroom is, just in case they need it.
IBS is not life-threatening, but it may have a severe impact on quality of life. Nevertheless, while currently there is no cure, symptoms often can be reduced and managed with lifestyle changes, medications, non-medication therapies, or combinations of approaches.
The key to achieving relief for IBS is for people to embrace the understanding that IBS is a complex motility (motor) and sensory disorder. It may have physical and stress-related dimensions. A strong partnership between a knowledgeable patient and an empathetic, knowledgeable health care provider can produce significant improvement and control over symptoms for individuals with IBS.
Good communication between the doctor and the patient is an essential part of care for people with symptoms of IBS. Most of the relevant information that is used to make a diagnosis is gathered by health care providers while talking with and listening to their patients. Also, effective communication during the course of care has been shown to significantly increase patient satisfaction, symptom improvement, daily function, and quality of life for patients.
General measures such as obtaining education about IBS, and identifying factors that trigger or worsen symptoms, such as certain foods or stress, are important starting points to help control IBS symptoms. Because the exact cause of IBS is not fully understood, there is no cure as of yet. Treatments are aimed at alleviating symptoms. Treatment may begin with implementing lifestyle changes, which may be associated with symptoms. Medications that regulate bowel function or relax intestinal spasm may be helpful.
IBS is very common: 10 to 15 percent of Americans are estimated to have IBS. The condition stems from an apparent disturbance in the interaction between the gut, the brain, and the nervous system that regulates the digestive tract. Because the cause is not easy to understand, some have dismissed the illness as being psychosomatic in nature. But experts have dismissed the idea that IBS is all in the heads of sufferers.
Leaders in the field now agree IBS is very real and have come up with a concrete way to diagnose it, based on symptom patterns. Treating IBS requires effective communication between patients and clinicians. Patients benefit from education about the disorder. A strong partnership between a knowledgeable patient and an empathetic, knowledgeable health care provider can produce significant improvement and control over symptoms for individuals with IBS.
IBS causes sufferers to lose time at work and gets in the way of the leisure-time activities they enjoy. The cost of caring for these patients has been pegged at $21.5 billion per year. Although there is no cure as of yet, many patients are helped by diet and lifestyle changes and relaxation techniques.