Irritable Bowel Syndrome

Irritable Bowel Syndrome is a term used frequently in Gastroenterological practice. Sometimes it used for no other reason than to be able to give a patient a diagnosis to hold on to when the Doctor really doesn’t know what is going wrong but has ruled out any of the common and serious bowel diseases. I’m not sure that this always helps but there can be no doubt that Irritable Bowel Syndrome exists, that it has many different sub-types and that all of them can be challenging to treat.

The gastro-intestinal tract is a long muscular tube lined by a smooth, inner surface. The muscular tube serves to push and propel the contents from your mouth down to your anus while the inner lining interacts with those contents, adding vital enzymes and secreting important hormones while absorbing all our essential nutrients. Irritable Bowel Syndrome describes abnormal function of that muscular tube.

  • Excessive muscular action will cause urgent bowel actions and diarrhoea.
  • Insufficient muscular action will cause slow colonic transit and constipation.
  • Uncoordinated muscular action will cause troublesome abdominal pain and bloating.
  • Combinations of these patterns will cause fluctuating diarrhoea, constipation, bloating and pain.

Despite the severity of these symptoms in some individuals, there is generally no disturbance of general health – no loss of appetite and no weight loss. As these features are generally indicative of a benign (not serious) process, they are reassuring for your Doctor. However, there is often considerable concern, even anxiety, on the part of the sufferer who doesn’t understand why they have their symptoms and might still be worried about the possibility of having something serious (such as bowel cancer).

These concerns can be dispelled by undergoing colonoscopy, which will confidently rule out serious large bowel pathology. Once you know that there is nothing serious about which to be concerned, your Doctor can guide you to the most appropriate treatment for whichever pattern of Irritable Bowel Syndrome you have.

I have found that the patterns of predominant diarrhoea and predominant constipation are generally the most likely to respond to treatment (anti-diarrhoeal medication and magnesium sulfate capsules respectively.) The patterns where abdominal pain predominates over a specific bowel disturbance or where the bowel disturbance fluctuates from one extreme to the other are undoubtedly more challenging to control.

In the treatment of all patterns of Irritable Bowel Syndrome it is critical to establish early on that there is no serious cause and to try to understand the connection – if one exists – between life stresses and your symptoms. Although understanding that such a connection exists doesn’t make your symptoms any less severe, it can greatly reduce your anxiety about them. Reassurance is often just as important as medication in many cases of Irritable Bowel Syndrome.

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