Irritable bowel Disease (IBS)

​Irritable bowel syndrome (often referred to as spastic colitis) is a disease entity characterised by symptoms from the digestive system for which there is no organic cause. Prominent are symptoms of abdominal pain and voiding disorders (either constipation or diarrhoea). It is a very common benign disease of the digestive tract and probably the most frequent reason for patients to come to the gastroenterology clinic, but it may also present with symptoms that significantly affect the daily life of patients.

Causes of Irritable Bowel Syndrome

​Many pathogenetic mechanisms have been proposed in the attempt to explain irritable bowel syndrome, but so far no clear cause has been found. Possibly different factors such as diet, food allergies, motility disorders, bacterial overgrowth syndrome as well as hypersensitivity and brain-gut interaction syndrome have been associated with irritable bowel syndrome and may interact with each other.

Symptoms

Although the symptoms vary from person to person, there are widely known and common symptoms that occur in almost all patients such as abdominal pain (like colic or period pain), a feeling of fullness and intense bloating even when not preceded by a rich-fat meal, alternating stools, either constipation or diarrhoea or a mixture of these. Often symptoms are relieved by stools while symptoms such as weight loss, or blood loss with stools are absent.

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Diagnosis

​There are no specific tests for irritable bowel syndrome. The diagnosis of irritable bowel syndrome is often a diagnosis to the exclusion of other organic bowel diseases. It is often necessary to perform iatological or imaging tests as well as colonoscopy to exclude other conditions with similar symptoms. In recent years, various breath tests such as lactose intolerance tests or lactulose or fructose tests have helped to detect other benign disorders with similar symptoms. 

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Addressing

​As the causes of the syndrome are often not known, there is no targeted treatment. Based on the predominant symptoms and the most likely pathogenic mechanism, the treatment of irritable bowel syndrome is individualised for each patient.

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A detailed record and subsequent change in eating habits is usually the first line of treatment for irritable bowel symptoms. Multiple diets have been suggested depending on the predominant symptoms. Fibre supplements and probiotics are often used as an adjunct to dietary modification. Medication is also useful for the treatment of abdominal pain but also for symptoms of constipation or diarrhoea. In recent years, low doses of antidepressants have also been used to reduce hypersensitivity in the patient.

An important role in the treatment of irritable bowel syndrome is for the patient to know that there is no organic disorder, which reassures the patient.