Irritable bowel or irritable bowel syndrome (IBS) is a common disease in the gastrointestinal tract and digestive organs. Typical symptoms include bloating and cramping stomach or abdominal pain.
What is irritable bowel syndrome?
One speaks of an irritable colon (colon irritabile) when there is a dysfunction of the digestive tract, which manifests itself with chronic complaints such as abdominal cramps, stool irregularities, as well as flatulence. A typical feature of irritable bowel syndrome is that the problems usually occur during the day and not during the night, and the doctor does not find any pathological changes in the organs or biochemistry of the body. Irritable bowel is not dangerous, but it is often very annoying for the affected person and the quality of life is limited, because the bowel reacts not only to some foods in an upset way, but also to stress. These restrictions caused by irritable bowel usually last not only days or months but sometimes many years and the patient must learn to cope with it.
Causes
The exact cause of this bowel disorder is not yet known. It is suspected that mental overload, caused by stress and anger, promotes irritable bowel syndrome. The messenger substance serotonin is thought to play a key role here, as it is responsible for the smooth flow of information between the brain and intestinal function. Furthermore, food intolerances naturally play a major role in irritable bowel syndrome, as do eating behavior and diet (e.g. hectic eating, irregular meals). The fact is that in irritable bowel syndrome, the movements in the intestines are disturbed and the perception of the normal digestive process is already perceived as painful. Researchers found that patients suffering from irritable bowel syndrome have an increased number of white blood cells, leukocytes. This would indicate inflammation of the intestinal mucosa and thus could be a cause of the symptoms.
Symptoms, complaints, and signs
The symptoms in irritable bowel syndrome are very diverse. The exact symptomatology allows a further typification of the condition. Thus, with predominantly soft bowel movements that occur approximately three times a day, the diarrhea type is spoken of. The constipation type is characterized by infrequent and hard bowel movements. There is also a mixed type, in which hard stools and diarrhea can occur on the same day, and irritable bowel syndrome without subtype. The latter refers to generalized symptoms. Those affected by IBS often complain of pain and a strong feeling of fullness. Flatulence and subjectively perceived bloating are much more unpleasant for those affected than for people without IBS. There is a clearly visible bloated abdomen in some sufferers. The pain is perceived as very severe. They can take the form of abdominal pain and cramps. They can often be described as stabbing or pulling. A feeling of bloating often leads to pressure pain. If pain occurs, defecation also occurs more frequently. The pain usually subsides after repeated defecation. However, the feeling of incomplete defecation often remains. Mucus may be mixed with the stool. As a rule, those affected are nevertheless symptom-free at night. Symptoms may be aggravated by stress and after food intake.
Course of the disease
Irritable bowel syndrome usually first appears between the ages of 20 and 30 and is common; twice as often in women as in men. In addition to the pain and cramps in the abdominal area, the following symptoms may also occur: Alternating diarrhea or constipation, a feeling of pressure in the lower abdomen, an altered stool composition (from hard to mushy to watery), flatulence, audible digestive noises, fatigue, poor concentration, anxiety, depression, sleep disorders, migraines and back pain. Those suffering from irritable bowel syndrome are often under severe suffering pressure, as these complaints limit the overall quality of life and often last a lifetime.
Complications
Irritable bowel syndrome does not usually lead to physical complications, even in a chronic course. If severe with diarrhea, dehydration may occur due to prolonged fluid loss, which should be prevented with adequate drinking and an adjustment in diet. The risk of dehydration can be eliminated by medical treatment.Irritable bowel patients are not at increased risk of other diseases of the gastrointestinal tract. If patients make changes to their diet or avoid selected foods without medical advice, weight gain or loss may result. Complications of a psychological nature regularly occur. The disease is often associated with fears, for example of colon cancer or subsequent damage. Depending on its severity, irritable bowel syndrome can lead to subjectively strongly felt restrictions in the patient’s everyday life, which generate restlessness, tension and anxiety. Patients suffer from fear of not having access to a toilet or appearing helpless in public when symptoms suddenly appear. Social isolation and depression may occur as a result. Other accompanying symptoms may include sleep disturbances, anxiety and psychosomatic symptoms. Feelings of shame, such as flatulence, can have negative effects on partnerships or sex life.
When should you go to the doctor?
People who suffer from irritable bowel syndrome are often very restricted in everyday life. All foods, especially fatty spicy foods, can not be digested properly in conjunction with the irritable bowel syndrome. Under certain circumstances, there may be stabbing stomach pains, which often occur immediately after consumption. A few minutes after the pain, diarrhea occurs and may last for several hours. Anyone suffering from irritable bowel syndrome should always consult an appropriate physician. By means of medication, the intestines and the stomach lining can be effectively soothed so that no pain occurs after eating the above-mentioned foods. However, if affected individuals refrain from doing so, then significant consequences are to be expected. The pain worsens over time, so that it persists even at rest. In particularly bad cases, there may even be permanent damage to the gastric mucosa, so that surgical intervention is unavoidable.
Treatment and therapy
Since a cure for irritable bowel syndrome is not possible according to current knowledge, attempts must be made to alleviate the symptoms in order to restore some quality of life to the patient. This can be helped by a holistic concept that combines changes in dietary habits, the administration of medication, and psychotherapeutic treatment. Since there is no standard irritable bowel diet, each patient must find out what is good for him and what is not; a food diary can help here. The foods that are not well tolerated must of course be rigorously avoided in irritable bowel syndrome. Drinking a sufficient amount of fluids per day has proven to be helpful, as this also has a beneficial effect on the intestinal mucosa. Medications for irritable bowel syndrome include antispasmodic and analgesic preparations, but only for acute therapy; often the well-tried hot water bottle is helpful. Swelling agents for diarrhea (e.g., psyllium), fiber (e.g., bran) for constipation, and defoamers (e.g., Lefax) for flatulence. As herbal helpers with the irritable bowel are to be named with priority, peppermint, camomile, caraway and anise. Finally, progressive muscle relaxation, hypnosis and psychotherapy can be tried to contain the daily stress somewhat to relieve the irritable bowel.
Aftercare
Aftercare following an acute irritable bowel disease should take into account the various triggering or exacerbating factors. These include, in particular, diet and avoidance of stress. In the case of chronic irritable bowel syndrome, patients should avoid the individual triggering or symptom-reinforcing factors. Foods that can trigger or exacerbate symptoms should be avoided. These include, for example, wheat-based products, lactose-containing dairy products, foods with a high fructose content, and foods with a high fat content. A favorable diet for people with irritable bowel syndrome includes cereal products, for example based on spelt, oats or rice, lactose-free dairy products, fruit with a low fructose content, and sweeteners with a low fructose content. If fats are used in food preparation, vegetable oils should be used. A diet or symptom diary can also help to shape the diet in such a way that the symptoms of irritable bowel syndrome are contained in the long term. Patients should also attend check-ups at regular intervals.These include, for example, screening examinations as part of colorectal cancer prevention. For people over the age of 55, the cost of colonoscopies is largely covered by health insurance.
What you can do yourself
Irritable bowel syndrome is one of the clinical pictures that are particularly receptive to self-help in everyday life. Cooperation of the patient is not only possible here, but also expressly desired. Diet, exercise, stress reduction and other factors are important for the optimal control of irritable bowel syndrome. In the area of nutrition, the patient must find out what actually does him or her good. Of course, recommendations such as avoiding spicy, fatty or flatulent foods are an important first step. However, patients can find out what is really tolerated in individual cases through targeted observation, such as keeping a food diary. This forms the basis for a gradual change in diet with regard to the IBS symptoms of those affected. Adequate nutrition and abstaining from alcohol and nicotine are also often helpful in this context. Exercise is an important factor in irritable bowel syndrome. This in two ways. On the one hand, being active efficiently stimulates the natural intestinal activity and is almost always recommended as a self-help in everyday life. In addition, stress reduction is also an important factor when it comes to everyday life with irritable bowel syndrome. Because the intestine does not only react to food influences. Psychological components also play a role with regard to the acute condition. Therefore, irritable bowel therapy and coping in everyday life should always be designed as a holistic concept.
