Irritable bowel syndrome (IBS) is a common health condition that usually affects individuals on a long-term basis. It is a digestive system disorder that affects the normal functioning of the large intestine or colon. The majority of the patients affected by this condition identify cases of cramping, constipation, bloating, diarrhea, gas and abdominal pain. Any one of these symptoms may ease up after opening bowels in the toilet. However, they can extend from a few days to a few months usually more prevalent during stressful situations or instances after consuming particular foods. The disorder may affect approximately twice as many women than men with its onset between the ages of 20 and 30. Medical records show that the disease may occur up to one in five people hence resulting in nearly 8 million hospital visits annually in the US. Even in cases where discomfort comes about from these symptoms, the condition does not lead to increased risk of colorectal cancer. The following paper discusses the diagnosis and treatment of the condition.
Diagnosis
Research has shown that approximately 9%-23% of the total world population suffers from the gastrointestinal (GI) disorder (Saha, 2014). In some cases, the studies show that nearly 15% of the global population is affected by the condition (Lacy, 2016). However, this may only be a representation of the individuals who are currently seeking treatment for the disorder. In the field of gastroenterology clinics, this group is the largest. The patients suffering from this condition usually receive a varied diagnosis from the numerous primary care physicians in the US. Despite its prevalence in the global community, the majority of the patients remain unaware of the proper diagnosis required resulting in additional tests. Nonetheless, there is minimal evidence to indicate that such practices may alter the ultimate findings. There are some IBS conditions each presenting symptoms for at least three or more days in a month for the previous three preceding months (Lacy, 2016).
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Since 1979, the criteria for diagnosis have experienced significant evolution; Rome I, Rome II to the most recent Rome III. The Rome II guidelines highlight that it to diagnose an individual with IBS, he or she must present discomfort that lasts approximately 12 weeks though it does not have to be consecutively over the past year (Lacy, 2016). Similar to the Rome III criteria, the patient should also indicate that the abdominal pain is relieved through defecation, the frequency of stool may have changed within the period or consistency of the stool may have changed (Wald, 2016). Any two of these symptoms may positively identify the presence of the condition. According to the guiding criteria, diagnosis may be conducted using the presented instances of symptoms without the need for further more specialized tests (Lacy, 2016). In such cases, the internists or family care practitioners may conduct the test themselves. There are cases where patients may complain of constipation but do not present infrequent stools.
The use of symptom-based diagnosis of the patient does not provide accurate data as per the statement position by the American College of Gastroenterology (ACG). According to the technique, it is usually a process of ruling out other diseases (Wald, 2016). However, there are cases where the IBS may occur in comorbid with functional GI among other extraintestinal disorders. The Manning criteria is also a standard diagnosis guideline that identifies the numerous symptoms including relief of abdominal pain by defecation, more frequent stool usually loose during the onset of pain, the presence of mucus in stool, abdominal distension and incomplete emptying of bowels. Though a specific number of symptoms for diagnosis is not indicated for the criteria a threshold of three means positive (Wald, 2016). During alarming symptoms, the patient may require significant attention for possible onset of severe conditions particularly colon cancer hence the need for additional testing. Such symptoms include new onset of IBS above the age of 50, anemia, nocturnal diarrhea that awakens an individual, sudden loss of weight at least 10% or more of body weight, rectal bleeding and fever (Wald, 2016).
Treatment
Medical practitioners and the associated researchers are yet to find significant data on the particular cause of the IBS condition. As a result, the majority of the treatment options are aimed at reducing the occurrence of the various presenting symptoms allowing for normal functioning of the digestive system and ensuring comfort (Lacy, 2016). Nonetheless, it is necessary that before discussing treatment options, the primary care physicians should address the disease-related concerns and educate the patient on the issue. According to research findings, individuals suffering from IBS have a poorer quality of life and usually utilize the health care treatment more than those without the diagnosis (Saha, 2014). In this regard, the physician should look into the patient’s health history and that of the family and address somatization issues that may be of greater benefit that the extensive testing (Lacy, 2016). The patients suspected of the condition may receive further testing to exclude diseases that may have similar symptoms to those of IBS.
There are four major groups of available laxatives in the US that ensure a significant increase in stool water content for directly through osmotic means or by increasing the bowel transit hence reducing absorption of water. These primary groups include bulk agents like calcium polycarbophil, nonabsorbed substances like PEG 3350, stimulants like bisacodyl, and secretory drugs like linaclotide (Saha, 2014). Many of such laxatives are available to patients even without prescription at an inexpensive price. However, the secretory agents developed in recent times require a prescription (Lacy, 2016). This group of drugs no longer target the general symptoms instead focus on the molecular level. For instance, Lubiprostone is a secretory drug that acts on chloride channels while the linaclotide target the guanylate cyclase receptors. Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are other pharmacological techniques that may be employed to rid of the condition or the usual symptoms (Wald, 2016).
Other non-pharmacological measures may be explored as a means of coping with the disorder. The majority of women diagnosed with IBS are depicted to have higher levels of psychological distress and psychopathology hence the use of relaxation techniques, and mind-body therapies could help. Exercise, for instance, could help manage GI function while simultaneously reducing levels of stress (Saha, 2014). For example, riding a bicycle has shown positive results in reduced cases of gas and protects aggravation of the current symptoms. Also, dietary modification is depicted as a significant factor towards the improved comfort of the patients. There are significant restrictions that enable relief of symptoms and enhance the quality of life (Lacy, 2016). Some of the foods that can be eliminated include foods that a patient is allergic to including dairy products, eggs, and yeast. Other foods to reduce may include wheat, coffee, potatoes and citrus fruits. Various offending carbohydrates such as fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) may aggravate IBS symptoms and should be avoided (Wald, 2016).
Conclusion
The above research shows that IBS is a common health condition affecting many Americans and global citizens alike. Despite its occurrence, members of the community have little knowledge about it. The literature available emphasizes the need for primary care physicians to educate patients on the issue as they provide numerous techniques for preventing its occurrence. The improved research on the public health problem has led to the development of highly effective drugs that eliminate the symptoms and allow the patient to lead a quality life. Without the presence of alarming signs, the condition can be appropriately managed through non-pharmacological practices that alleviate the pain and ensure comfort without aggravating the prevailing symptoms.
References
Lacy, B. E. (2016). Diagnosis and treatment of diarrhea-predominant irritable bowel syndrome. International Journal of General Medicine , 9, 7-17.
Saha, L. (2014). Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World Journal of Gastroenterology: WJG , 20(22), 6759-73.
Wald, A. (2016). Constipation: advances in diagnosis and treatment. JAMA , 315(2), 185-191.
