::::|| VU ||:::: IRRITABLE BOWEL SYNDROME

IRRITABLE BOWEL SYNDROME

Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain is associated with defection or a change in bowel habit. Approximately 20% of the general population fulfills diagnostic criteria for IBS but only 10% of these consult their doctors because of gastrointestinal symptoms. Nevertheless, IBS is the most common cause of gastrointestinal referral and accounts for frequents absenteeism from work and impaired quality of life. Young women are affected 2-3 times more often than men. Co-existing conditions such as non-ulcer dyspepsia, chronic fatigue syndrome, dysmenorrhoea and fibromyalgia are common.

Diagnosis

The diagnosis is clinical in nature and can be made confidently in most patients
under the age of 40 years without resorting to complicated tests. 
Colonoscopy should be undertaken in older patients to exclude colorectal cancer.
Features of irritable bowel syndrome                                          

Alarm features
·	Colicky abdominal pain	·	Altered bowel habit
·	Feeling of incomplete defection	·	Abdominal distension
·	Rectal mucus

                  Supporting diagnostic features and alarm features in IBS

Features supporting a diagnosis of IBS:
·	Symptoms > 6 months	·	Previous medically unexplained symptoms
·	Frequent consultations for non-G problems	·	Stress worsens symptoms

 

Alarm features
·	Age > 50 years; male gender	·	Family history of colon cancer
·	Weight loss	·	Anemia
·	Nocturnal symptoms	·	Rectal bleeding

Management

The most important steps are to make a positive diagnosis and reassure the patient. Many patients are concerned that they have developed cancer, and a cycle of anxiety leading to colonic symptoms, which further heighten anxiety, can be broken by explanation that symptoms are not due to organic disease but are the result of altered bowel motility and sensation. In patients who fail to respond to reassurance, treatment is tailored to the pre-dominant symptoms.

Drug therapy for IBS

Evidence for efficacy of drug therapy for IBS is weak. There is evidence of benefit for antispasmodic drug for abdominal pain and overall response but there is no clear evidence of benefit for antidepressants or bulking agents. For each individual, treatment should be aimed at the most debilitating symptoms.

 

Life is labor, death is rest.

Thanks & Best Regards,

Dr. Mohammad Kashif Mahmood.

MD / FP

Al-Mustafa Medicare

E-mail address: dr.mkm12@gmail.com

Mobile # +0092-308-7640486