Irritable Bowel Syndrome
This is probably the commonest presenting condition to Gastroenterology clinics. It is interesting in that there does not seem to be a recognisable cause for the symptoms or indeed, pathological process that seems to be responsible for the symptoms. No obvious abnormality has been detectable in the bowel and the condition probably arises from incoordination of bowel motility, although food intolerances (NOT allergies) may also be partly responsible.
Symptoms A syndrome is a group of symptoms and signs that collectively go together to describe a medical condition. In the instance of irritable bowel syndrome the symptoms comprise the following; • diarrhoea or constipation or both • abdominal bloating and distension • excess mucus production • acid reflux • often cyclical with menstruation • can be associated with bladder instability and urinary frequency
Investigation The symptoms are frequently aggravated by stress, mental illness, poor sleep pattern (shift work etc) and chronic pain. Unfortunately these symptoms may also be seen in other more serious conditions and therefore patients with IBS frequently undergo a plethora of normal investigations before the diagnosis is eventually reached!
Management As the cause of IBS is likely to be multifactorial (and often brought on by the stresses of daily living), no single treatment appears to be effective. The following treatments have been found to be effective in some patients but unfortunately there is no panacea! • dietary exclusion, • stress management, • acupuncture, • psychotherapy, • anti-spasmodic drugs (such as mebeverine, peppermint oil) • low dose tricyclic antidepressants Written by Dr M J Webberley, Consultant Gastroenterologist, August 2015