Symptoms are similar to other GI disorders. This also makes it hard to diagnose. There are no diagnostic tests for IBS - no lab test, no imaging, no other type of test. Doctors use the Rome IV criteria to help diagnose. It is very specific and means a person has had recurring abdominal pain at least once a week in the last three months. When making an IBS diagnosis with this criteria, doctors also include the length of time a person has had symptoms before IBS was diagnosed - in this case at least six months.
IBS can be treated, as described below. Small amounts of bright red blood usually turn out to be from a hemorrhoid or small tear fissure in the anal passage. Rarely, it could be due to another condition that requires treatment.
On the other hand, large amounts of red blood or black, tarry-colored stool calls for urgent medical attention. Learn more about alarm symptoms. Increased Personal Risk — Sometimes there is a factor in your life that may put you at greater than average risk of acquiring a serious intestinal disease. For example, if a parent or sibling has had colon cancer or even a precancerous colonic polyp, then your risk of polyps is greater than normal.
Celiac disease, where essential nutrients fail to be absorbed, has its greatest prevalence among the descendants of people born in Northern Europe.
IBS patients are as likely as anyone to suffer an intestinal infection, which may add to and confuse the symptoms. You should be suspicious of an infection if:. IBS follows an unpredictable course. There may be periods of relative calm, mixed back and forth with periods of pain or discomfort, and chaotic bowel habits that interfere with your life. However, if the basic pattern of your bowel symptoms changes or one of the situations described above occurs, a visit to your healthcare provider is in order.
Sometimes a drug you are taking for another purpose or something new in your diet may be responsible for the change, and your healthcare provider can help you determine that. A visit also provides your healthcare provider with the opportunity to review your diet, exercise habits, and drug regimen, and perhaps recommend changes. Learn more about working with your healthcare provider. IBS is long-term chronic and tends to repeatedly come and go over time. It does not predispose you to other GI diseases.
However, IBS does not protect you from other digestive conditions, and overlap is possible. New and different symptoms may make you suspicious that something new is happening. You should visit your healthcare provider if you become aware of alarm symptoms or of a factor that might put you more than normally at risk of another disease. Two examples include dicyclomine Bentyl and hyoscyamine Levsin.
Studies show these drugs have limited effectiveness and are best used when symptoms develop soon after meals. Antidiarrheals such as loperamide Imodium. These medications are quite effective for diarrhea and may be prescribed as needed to help with loose, frequent stools or urgency. Bulk laxatives such as fiber may be in order if your primary symptom is constipation.
These include psyllium Metamucil , methylcellulose Citrucel and calcium polycarbophil Equalactin. Alosetron Lotronex is approved for use in female patients who have severe diarrhea and abdominal pain as symptoms of IBS. It is a 5HT 3 receptor antagonist and inhibits the action of serotonin in the gut. Lotronex was withdrawn from the market soon after it was introduced because of safety concerns, but it was subsequently reintroduced and is currently available.
However, because of its potentially serious side effects, Lotronex should be used only in patients with severe symptoms who are cared for by a gastroenterologist, and certain prescribing guidelines must be followed. Tricyclic antidepressants such as amitriptyline Vanatrip, Elavil, Endep , desipramine Norpramin and nortriptyline Pamelor, Aventyl are often used for symptoms of pain and diarrhea.
They are used in doses lower than the dose used for depression and are believed to work by decreasing the pain signals between the gut and brain. These medications may also help with sleep disturbances as well as fibromyalgia, which is commonly seen with IBS. Selective serotonin reuptake inhibitors SSRIs may also be prescribed to alleviate the accompanying depression and anxiety suffered by some IBS patients. Other types of antidepressants may also be recommended, including mirtazapine Remeron , venlafaxine Effexor and duloxetine Cymbalta.
Anti-anxiety medications help reduce anxiety that can worsen IBS symptoms. Physicians occasionally prescribe anti-anxiety drugs such as diazepam Valium , lorazepam Ativan and clonazepam Klonopin for people with short-term anxiety that is worsening their IBS. These drugs should only be taken with close follow-up by your doctor, however, because they can become addictive.
Lubiprostone Amitiza is a drug that increases intestinal fluid secretion. It is used to treat severe constipation and IBS in women over 18 who have not responded to other treatments.
Antibiotics may play a role in the treatment of IBS, but the exact role is unclear at this point. Some people whose IBS symptoms are caused by an overgrowth of bacteria in the intestines may benefit from antibiotics, but no antibiotic is currently approved for this use yet. Here are some tips that might help: Eat at regular hours; chew food slowly and thoroughly; avoid large or high-fat meals or excess caffeine.
Get regular physical activity. It can help relieve the symptoms of anxiety and also promotes good bowel function.
Avoid delaying the urge to have a bowel movement. Avoid straining during a bowel movement; try to relax and take your time. The following strategies may help prevent attacks: An eating schedule.
Eating causes contractions of the colon. Normally, this response may cause an urge to have a bowel movement within 30 to 60 minutes after a meal. If you have IBS, this urge may come sooner and trigger cramps and diarrhea. Smaller meals. The strength of the response is often related to the number of calories in a meal and especially the amount of fat.
Also, large meals can cause cramping and diarrhea in people with IBS. Symptoms may be eased if you eat smaller meals more often or just eat smaller portions. But try to stay on a regular eating schedule either way. Dietary changes. For some people, a low-fat, higher-fiber diet may help. Other people feel better with a high-protein, low-carbohydrate diet. Fat greatly stimulates colon contractions following a meal.
Caffeine causes loose stools in many people and is more likely to affect those with IBS. The key is that the diet needs to be individualized for each person. Dietary fiber may lessen constipation in many cases but does not lessen pain.
Whole-grain breads and cereals, beans, fruits and vegetables are good sources of fiber. Over-the-counter fiber supplements can also provide valuable fiber, but consult your health care professional before using them. Certain medicines including antibiotics may trigger IBS attacks in some people.
Be sure to tell all your health care professionals about your condition and discuss other medication options that can avoid triggering IBS symptoms. Physical, emotional and environmental stress may exacerbate or trigger symptoms. Prevention Irritable bowel syndrome IBS isn't a condition that can be "prevented. It has been called by many names—colitis, mucous colitis, spastic colon, spastic bowel and functional bowel disease.
Most of these terms are inaccurate. Colitis, for instance, means inflammation of the large intestine the colon , while IBS doesn't cause inflammation. IBS symptoms affect up to 20 percent of the general population and a higher percentage of women. It is the most common disorder diagnosed by gastroenterologists, and is among the most common health disorders in general.
Women are twice as likely as men to suffer from IBS. Moreover, they seem to have more symptoms during their periods, suggesting that reproductive hormones play a role. IBS is a chronic condition. Typical onset occurs in the late 20s. You might have it for years—even all your life. Fortunately, the symptoms may come and go. IBS can be triggered by stress, and symptom flares are associated with major stressful life events in the majority of patients.
Studies indicate that some psychological treatments, such as cognitive behavioral therapy, can alleviate abdominal pain and diarrhea associated with the syndrome. Although there is no cure, IBS is treatable. Symptoms can often be managed with dietary or lifestyle changes; in more severe cases, medication may be needed.
Surgery is never considered a treatment option. There is no known single, specific cause for IBS. IBS symptoms vary by individual. Certain medicines and foods may trigger attacks. Other conditions often accompany IBS, such as fibromyalgia, interstitial cystitis a bladder condition , anxiety and depression. Questions to Ask Review the following Questions to Ask about irritable bowel syndrome so you're prepared to discuss this important health issue with your health care professional.
How much experience do you have treating irritable bowel syndrome IBS? Should I see a specialist? What tests are used to diagnose IBS? The discomfort frequently starts shortly after eating and may go away after a bowel movement. But that is not always the case. Diarrhea or Constipation - Bouts of diarrhea and constipation, or sometimes fluctuating between the two states, are other common symptoms.
People with IBS often feel they need to stay home or near a bathroom for these reasons. So if you find yourself reaching for elastic-waist pants after eating, it could be a sign of IBS. Publicly passing gas can be humiliating. Mucus in Stool - It is normal to pass a small amount of mucus in your stool. However, people who have IBS may notice increased amounts of mucus in their stool.
Tests may include: Stool sampling Blood tests X-rays Colonoscopy You should see your primary doctor or a doctor specializing in gastrointestinal services if you are experiencing IBS symptoms.
What Causes IBS?
0コメント