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Irritable Bowel Syndrome.
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Irritable
Bowel Syndrome (IBS) belongs to a group of conditions called
Medically
Unexplained Diseases or Disorders (MUD). Fibromyalgia Syndrome is also
in this group. IBS is a functional disorder. In other words, you have
symptoms but there is no structural abnormality. It is the most common
condition seen by Gastroenterologists and the most common
gastrointestinal condition seen by the family doctor.
Diagnosis
of IBS is easier since the introduction of the Manning
Criteria and
more recently the Rome Criteria. The Rome 11 Criteria gives family
physicians the confidence to make a diagnosis of Irritable Bowel
Syndrome without
invasive tests. This is very useful especially in the very young.
IBS is a very common condition and, as a large percent of sufferers do
not see their GP, the incidence could be as high as 20% globally. It is
more common in women. It is also a heavy burden not only to the
sufferer but to the health professionals and health providers.
Abdominal pain is an important symptom in the diagnosis of
Irritable
Bowel Syndrome. A patient attended my surgery and said she had IBS.
Her
only symptom was bloating. She had a flat tummy when she woke up but by
the end of the day, she looked like she was nine months pregnant. She
had no pain or altered bowel habit or form. This is not Irritable Bowel
syndrome but one of the many functional disorders that affect the gut.
Thompson and Heaton produced a long list of functional gastrointestinal
disorders. Quite a few overlap with Irritable Bowel Syndrome.
For the diagnosis
of IBS, according to the Rome 11 Criteria, you must
have abdominal pain or discomfort for at least 12 weeks in a year plus
two of the following in the absence of structural or metabolic
abnormalities to explain the symptoms. Relief of pain with defecation.
Pain associated with change in frequency of bowel movement. Pain
associated with a change in form of stools.
IBS sufferers also have rectal symptoms such as urgency and incomplete
emptying. Urgency can cause faecal incontinence. Although this is
uncommon, it is a source of severe embarrassment. Bloating is common in
Irritable Bowel Syndrome. IBS sufferers are aware of their rumbling
tummy and wind. Mucus was a common feature in the past but is not a
significant feature today.
Non colonic symptoms of IBS include tiredness and lethargy, urgency and
frequency to micturate, backache, pain during intercourse and painful
periods in women.
Statistics show that a large percent of Irritable Bowel Syndrome
patients wait years before seeing a doctor. These individuals are
making their own diagnoses. IBS patients should have a diagnosis
established by a health professional. Some serious illnesses have
similar symptoms as
IBS. Subclinical Ulcerative Colitis can mimic
Irritable Bowel Syndrome.
Patients who suspect they have
Irritable Bowel Syndrome must see their
doctor if they have any of the following symptoms. Unexpected weight
loss, loss of appetite (anorexia), bleeding from the rectum and
symptoms first appearing after the age of 50. See your family doctor if
you have IBS
symptoms and you have a family history of colon cancer or
polyp. There is a higher incident of haemorrhoids (piles) in Irritable
Bowel Syndrome and haemorrhoids can cause bleeding from the rectum.
Bleeding from the rectum is, however, a red flag symptom and can point
to serious underlying disease. Check it out.
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Caraway.
