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Irritable Bowel Syndrome

What is IBS (Irritable bowel syndrome)?

Woman holding stomachIrritable bowel syndrome is a gastrointestinal condition that causes recurrent attacks of abdominal pain or discomfort in association with bowel habits. It affects up to 5-10% of individuals worldwide and it can affect children and adults of both genders. IBS does not affect life span of a person however it is associated with a large health care and economic burden. Studies have shown that IBS patients have an increased number of health care visits, diagnostic tests, and surgeries. IBS can also severely impact a person’s quality of life.

This disorder usually begins in the teens and 20’s which include bouts of irregularly recurring symptoms. The cause and pathophysiology of this disorder is unknown because no anatomic cause can be found on labs, x-rays or biopsies. Emotional factors, hormones, diet or drugs can pre-empt abdominal symptoms. It is also attributed to a combination of psychosocial and physiologic factors. Potential causes of IBS include:

  • Hypersensitivity: some people with IBS have a lower pain threshold to bloating and cramping in their intestines
  • Infection: bacterial gastroenteritis may trigger IBS in some people
  • Stress: stressful events, such as work or marriage difficulties, or the death of someone close, may also trigger symptoms of IBS. Psychological stress can be expressed through physical symptoms. Stress can also worsen IBS
  • Body chemicals: levels of neurotransmitters (chemicals that transmit nerve signals) and digestive tract hormones are altered in some people with IBS. Reproductive hormones appear to worsen symptoms
  • Bacterial overgrowth: IBS has been associated with a surplus of bacteria in the intestines
  • Changes in the intestinal microbiome: these are the ‘friendly’ bacteria that live in the gut, which are important for digestion and health in general. The microbiome in people with IBS appears to differ from that in healthy people.
  • Food intolerances: many people with IBS report that some foods and beverages can cause symptoms.

Classifications of Irritable Bowel Syndrome:

  • A type (Combination of diarrhoea & constipation): Some people have another type called irritable bowl syndrome with mixed bowel habits, or IBS-M. IBS-M is also sometimes called IBS with alternating constipation and diarrhea (IBS-A). If you have this form of IBS, your stools on abnormal bowel movement days will be both hard and watery. Both must occur at least 25 percent of the time each, in order to be classified as IBS-M or IBS-A.
  • C type (Constipation predominant): IBS-C, is one of the more common types. It includes abnormal bowel movement days consist of stools that are at least 25 percent hard or lumpy, but also less than 25 percent loose in consistency. With this type of IBS, you’ll experience fewer bowel movements overall, and you may sometimes strain to go when you do have them. IBS-C can also cause abdominal pain that accompanies gas and bloating.
  • D type (Diarrhoea predominant): IBS-D is also known as IBS with diarrhea. This type of IBS causes the opposite issues with IBS-C. With IBS-D, more than a quarter of stools on your abnormal bowel movement days are loose, while less than a quarter are hard and lumpy. If you have IBS-D, you may also feel abdominal pain along with more frequent urges to go. Excessive gas is also common.

Signs and Symptoms:

  • Lower abdominal cramping.
  • Change in stool frequency and consistency. Increased frequency in diarrheal dominant IBS and decreased frequency in constipation dominant IBS
  • Excessive gas and bloating
  • Pain relieved by defecation

Diagnosis:

The diagnosis of Irritable bowel Syndrome is largely based on history. The predictive Diagnostic Criteria may include:

  • Pain relief with bowel movement
  • More frequent stools with the onset of pain
  • Looser stools with the onset of pain
  • Passage of mucus
  • Sensation of incomplete defecation
  • Abdominal distention sensed through tight clothing or visibly evident

Medical treatment:

The medical treatment may include:

  • Antidiarrheal drug such as alosetron (Lotronex) for women only, antibiotics, such as rifaximin (Xifaxan), eluxadoline (Viberzi) and loperamide (Diamode, Imodium A-D)
  • Anticonstipation drugs such as linaclotide (Linzess), lubiprostone (Amitiza) plecanatide (Trulance) and supplements (fiber and laxatives).
  • Possibly antidepressant treatment or psychosocial therapy.

Dietary changes can also help control symptoms of irritable bowl syndrome. Eating at about the same time each day should help regulate bowel function. Foods that typically make IBS symptoms worse should be limited or avoided e.g. Alcohol, chocolate and caffeinated beverages. Adequate hydration may also be beneficial. Keeping a food diary may help determine what effects different food have on your body.

Chiropractic Management

In terms of Chiropractic care, the objective of Chiropractic is to locate, analyse and correct any spinal dysfunction. These spinal dysfunctions can be caused by physical, mental and/or chemical stress. Having long term discomfort in abdomen can cause dysfunction in the spine specifically in lumbar and pelvic region. The nerves affecting the function of these organs also origin from the spinal cord.

Therefore, getting your spine checked helps to correct any spinal dysfunction present throughout your spine which ultimately leads to the optimal function of the brain and the body. If you would like further information and would like to get your spine check, talk to your nearest Chiropractor and start your journey today.
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