IRRITABLE BOWEL DISEASE (IBD)

By Pharm Precious Udoaka 

Overview

Irritable Bowel Disease (IBD) is also known as Irritable Bowel Syndrome (IBS). It is a common gastrointestinal disorder characterized by abdominal pain, discomfort, and changes in bowel habits. It is a functional disorder, meaning there are no structural abnormalities, but it affects how the digestive system works.

Is there a cure for IBS?

There isn’t a cure for IBS. But, most people manage symptoms by avoiding triggers and taking medications when necessary.

Types

There are several types of IBS, including:

• IBS with constipation (IBS-C)
• IBS with diarrhea (IBS-D)
• Mixed IBS (IBS-M), which involves both diarrhea and constipation
• Unsubtyped IBS (IBS-U), where the bowel habits do not fit into the other categories

Signs/Symptoms

Common signs and symptoms of IBS include:

• Abdominal pain or discomfort, often relieved by bowel movements
• Changes in bowel habits, such as diarrhea, constipation, or alternating between the two
• Bloating and gas
• Mucus in the stool
• Feeling of incomplete bowel movements
• Fatigue
• Anxiety or depression

Causes

The exact cause of IBS is unknown, but it likely involves a combination of factors, including abnormalities in the gut-brain axis, intestinal motility, sensitivity to certain foods, and changes in the gut microbiota.

• Muscle contractions in the intestine. The walls of the intestines are lined with layers of muscle that contract as they move food through your digestive tract. Contractions that are stronger and last longer than usual can cause gas, bloating and diarrhea. Weak contractions can slow food passage and lead to hard, dry stools.
• Nervous system. Issues with the nerves in your digestive system may cause discomfort when your abdomen stretches from gas or stool. Poorly coordinated signals between the brain and the intestines can cause your body to overreact to changes that typically occur in the digestive process. This can result in pain, diarrhea or constipation.
• Severe infection. IBS can develop after a severe bout of diarrhea caused by bacteria or a virus. This is called gastroenteritis. IBS might also be associated with a surplus of bacteria in the intestines (bacterial overgrowth).
• Early life stress. People exposed to stressful events, especially in childhood, tend to have more symptoms of IBS.
• Changes in gut microbes. Examples include changes in bacteria, fungi and viruses, which typically reside in the intestines and play a key role in health. Research indicates that the microbes in people with IBS might differ from those in people who don't have IBS.

Triggers may include stress, certain foods, hormonal changes, and gut infections

Risk factors

Many people have occasional symptoms of IBS. But you're more likely to be at risk if;

• IBS occurs more frequently in people under age 50.
• Estrogen therapy before or after menopause.
• Genes may play a role, as may shared factors in a family's environment or a combination of genes and environment.
• A history of sexual, physical or emotional abuse also might be a risk factor.

Diagnosis

• The first step in diagnosing IBS is a detailed medical history. Your provider will ask about your symptoms
• Laboratory tests including blood tests, stool tests and hydrogen breath tests
• Imaging tests including colonoscopy, flexible sigmoidoscopy and upper endoscopy

Treatment/Management

Treatment for IBS focuses on relieving symptoms and improving quality of life. Treatment options may include:

• Dietary modifications, such as avoiding trigger foods (e.g., gas-producing foods, high-fat foods, gluten, dairy) and following a low-FODMAP diet
• Fiber supplements for constipation-predominant IBS
• Medications, such as antispasmodics for abdominal pain, laxatives for constipation, or anti-diarrheal agents for diarrhea
• Probiotics to help restore a healthy gut microbiota
• Stress management techniques, such as relaxation exercises, cognitive-behavioral therapy (CBT), or mindfulness-based stress reduction (MBSR)
• Regular exercise and adequate sleep
• Prescription medications for more severe symptoms, such as tricyclic antidepressants or certain serotonin receptor modulators
• Judicious water intake is recommended in patients who predominantly experience constipation
• Caffeine avoidance may limit anxiety and symptom exacerbation

Prevention

While IBS cannot be prevented, certain lifestyle measures may help manage symptoms and reduce flare-ups. These include:

• Eating regular, balanced meals and staying hydrated
• Avoiding trigger foods and beverages
• Managing stress through relaxation techniques, exercise, and hobbies
• Getting regular physical activity
• Avoiding smoking and excessive alcohol consumption
• Seeking prompt medical attention for any new or worsening symptoms

In conclusion, Individuals with IBS should work closely with their healthcare providers to develop a personalized treatment plan tailored to their specific symptoms and needs. Regular communication and monitoring are important for managing the condition effectively.