Irritable Bowel Syndrome: a common disorder

 Irritable bowel syndrome is a common disorder affecting the large intestine, more precisely the colon, but fortunately it doesn’t cause inflammation or permanent damage to the colon, nor increases the risk of colon cancer as other more serious intestinal diseases do.

 Symptoms are uncomfortable and include abdominal pain or cramping, bloating, flatulence, as well as diarrhoea and/or constipation. These symptoms are usually mild and often improve by simply controlling the condition with a proper dietary regimen. However, in some patients, symptoms are more severe and sometimes can lead to complications such as haemorrhoids and malnourishment.

 The exact cause of irritable bowel syndrome is not known and many factors have been hypothesized to come into play, including a particular sensitivity and reactivity of the colon to certain foods and stress, an abnormal or uncoordinated motility of the colon, bacterial infections and certain food intolerances such as celiac disease. Although the exact cause still remains unclear, certain risk factors have been clearly identified. These include age under 35 years, female gender and a family history of irritable bowel syndrome.

 Since the cause of irritable bowel syndrome is not known, the treatment can be only symptomatic. As already said, in many cases a proper dietary regimen is enough to relieve or prevent the occurrence of symptoms. First of all it is important to avoid or limit foods that can trigger or worsen symptoms, such as dairy products, chocolate, beans, caffeinated beverages, alcohol and sugar-free sweeteners.

A high-fiber diet can help relieve symptoms of constipation, but it is not recommended for patients in which the main symptom is diarrhoea. In the last case, it may be helpful to eat several small, frequent meals throughout the day, in order to help regulate the intestinal function. Another important measure to prevent the occurrence of symptoms is stress management, since stress is often a triggering factor for irritable bowel syndrome.

Severe Irritable Bowel Syndrome

 When symptoms are severe, medications are prescribed by the doctor. The type of medication prescribed depends on which symptoms are present. Fiber supplements and laxatives can be helpful to relieve or prevent constipation, while anti-diarrhoeal medications can help control diarrhoea. Many doctors also prescribe antispasmodics, which help control muscle spasms of the colon and relieve abdominal pain, and sometimes antibiotics, which are effective only when irritable bowel syndrome is associated with or accompanied by an overgrowth of bacteria in the colon, while in the other cases they are unhelpful and ineffective. Finally a hint has to be given to alosetron and lubiprostone, to drugs approved only for women to treat diarrhoea or constipation, respectively. However, due to their possible serious side effects, these drugs are prescribed only when all the other treatments have failed.

 Some patients can also find relief from certain alternative therapies, including acupuncture, herbs, probiotics (helpful bacteria which normally live in the intestine and are also found in yogurt and dietary supplements), as well as yoga and other relaxation aids.

 Since the treatment of irritable bowel syndrome often requires the use of medications for prolonged periods of time, its cost should be covered by an appropriate international health insurance plan.