Irritable bowel syndrome is a functional gastrointestinal disorder characterized by abdominal pain and changes, and its mechanism is not yet fully understood, but it likely involves heightened sensitivity of the intestines (visceral hypersensitivity) as a central component.
For example, some individuals with irritable bowel experience diarrhea, while others may suffer from constipation. The main common component for different patients with irritable bowel syndrome is abdominal pain.
This syndrome usually develops in individuals under the age of 45, and it is more prevalent in women compared to men, with about 10-15% of the general population experiencing this condition.
What are the symptoms of irritable bowel?
The symptoms of irritable bowel include abdominal pain, and cramps (usually in the lower abdomen), often associated with bowel movements, and there is often relief from pain after bowel movements.
Other symptoms include excessive gas, mild or more severe bowel activity than usual, and changes in stool frequency, consistency, or appearance.
What causes irritable bowel?
The specific cause of the syndrome is not entirely known, and it likely involves multiple different factors. The intestines consist of layers of muscles that contract and relax, allowing food to move through the digestive tract. In people with irritable bowel syndrome, it is possible that the intestinal contractions are stronger and last longer, leading to gas, bloating, and diarrhea. Conversely, a decreased number of contractions can cause slow movement of food, resulting in constipation.
Another contributing factor may be a dysfunction in the gastrointestinal nervous system. Lack of coordination between brain signals and the digestive system can lead to abnormal responses during digestion, resulting in pain, diarrhea, or constipation. Some patients with irritable bowel may also have increased gut permeability.
The triggers for irritable bowel syndrome and its exacerbation vary from person to person, but some common triggers include:
- Certain foods, such as chocolate, spices, fats, fruits, beans, cabbage, broccoli, milk, carbonated drinks, and alcohol.
- Psychological stress.
- Hormones - changes in hormonal levels, especially during the menstrual cycle, have been linked to the syndrome and its exacerbation.
- Other health conditions - such as severe gastroenteritis (inflammation of the intestines due to infection).
Risk factors:
- Young age - under 45 years old.
- Female gender.
- Family history of irritable bowel syndrome, suggesting a possible genetic or shared environmental link.
- Psychological disorders - such as anxiety, depression, or personality disorders.
How is irritable bowel diagnosed?
Diagnosis is made using the Rome III criteria, which are clinical criteria lasting for more than three months without any signs of concern such as significant weight loss or anemia. Physicians usually rule out other possible diagnoses before confirming irritable bowel syndrome. The depth of investigation depends on the individual's medical history and examination findings.
Some symptoms that may require further investigation include:
- Symptoms appearing after the age of 50.
- Unintended weight loss.
- Rectal bleeding.
- Fever.
- Nausea and vomiting.
- Abdominal pain that worsens in the evenings and disturbs sleep.
- Persistent diarrhea that wakes you up from sleep.
- Anemia due to iron deficiency.
If you meet the diagnostic criteria for irritable bowel syndrome (abdominal pain or discomfort lasting for over three months) and don't have any of the above symptoms, your doctor may decide on treatment without further investigations.
However, if you do not respond to the initial treatment, further investigations may be necessary, such as sigmoidoscopy (a brief colonoscopy showing only the lower part of the large intestine), full colonoscopy, abdominal imaging, lactose tolerance test, celiac disease blood test, or stool test if you have chronic diarrhea.
How is irritable bowel treated?
Treatment for irritable bowel syndrome is carried out on various levels, including lifestyle and dietary changes, as well as drug therapy. Some patients may also benefit from addressing the psychological aspect that can worsen the condition. In Sheba Medical Center, a multidisciplinary team of gastroenterologists, dietitians, and medical psychologists work together to tailor the treatment individually to each patient.
Additional treatment and complementary medicine may include:
- Chinese acupuncture.
- Herbal remedies - some claim that peppermint oil helps soothe the smooth muscles of the intestines. However, before using any herbal remedies, make sure they do not interfere with your current medications.
- Hypnosis.
- Probiotics.
- Exercise.
Note: The information provided on this website is not intended to establish a doctor-patient relationship. The information is not medical advice and cannot replace consultation with a physician or any other healthcare professional. The user is solely responsible for their actions based on this information.