Irritable Bowel Syndrome or “Spastic Colon” Frequent, Irritating and “Innocent”.

Written by Georgios K. Anagnostopoulos

Gastroenterologist – Hepatologist - Endoscopist

Collaborator of MITERA Gastroenterology Endoscopy Department

Irritable Bowel Syndrome is a problem in the large intestine which shows various symptoms such as abdominal pain, tympanism, diarrhoea and constipation.

Irritable bowel syndrome is not a disease; it is a functional disorder in which the large intestine does not function properly. It seems that in the irritable bowel syndrome, nerves and muscles on the intestinal wall are very sensitive. Muscles may be contracted more than usual after meal and pain and tympanism may appear. Furthermore, nerves may be very sensitive when gases provoke intestinal growth and patient may feel pain. In addition to those aforementioned, some changes are observed in the time needed for the food to get from the stomach to the rectum and to discharge of the food causing this way diarrhoea or constipation. Irritable bowel syndrome may be disturbing but it does not affect the intestines and it does not cause any more disorders.

How frequent is it?

The symptoms of the irritable bowel syndrome are very often in the population. About 20% of Americans and Europeans fulfil the syndrome diagnostic criteria. Irritable bowel syndrome is met more often at the ages of 30-65 and rarely at the ages 65-90. Symptoms frequency is almost the same for both sexes.

Can stress be the cause of Irritable Bowel Syndrome?

If a person suffers from Irritable Bowel Syndrome, stress may lead to resurgence of its symptoms, but stress is not the reason for Irritable Bowel Disease.

What are the symptoms of the Irritable Bowel Syndrome?

Irritable bowel symptom has multiple symptoms. Among these are the following: abdominal pain and dysphoria, abnormal intestinal discharges, such as constipation, diarrhoea or interchanging of these two and tympanism. Abdominal pain varies in intensity and location. It usually is a chronic pain with recessions and resurgences but it can also be continuous. Frequently it appears or becomes worse with meals. Patient feels relieved with discharges and gas eliminations and symptoms are related with changes in the frequency of the discharges or in the composition of faeces.

How can it be diagnosed?

There is no special examination for the Irritable Bowel Syndrome. It can be diagnosed based on the patient’s medical history and clinical examinations and in few patients a test is required to rule out more serious diseases with similar symptoms.

When a comprehensive screening with blood test and colonoscopy should be performed before diagnosing the irritable bowel syndrome?

A comprehensive screening should be performed if:

  • Symptoms appeared after the age of 50;
  • there is pain or diarrhoea that wakes the patient at night;
  • there is blood in faeces;
  • there is fever or loss of weight;
  • there is a family history of organic digestive diseases (cancer, idiopathic inflammatory bowel disease).

Furthermore, all patients older than 50, should be subjected to colonoscopy to prevent colorectal cancer development.

What is the treatment for the irritable bowel syndrome?

A. Diet

It is recommended to increase the uptake of fibres contained in fruits, vegetables, cereals and pulses. Fibres are useful especially in the irritable bowel syndrome with constipation symptoms but some fibres may cause gases to some patients and therefore they may worsen the symptoms.

B. Exercise and less stress

Both exercise and stress release are recommended to all patients because they make the symptoms of the irritable bowel syndrome less intense.

C. Medication

Spasmolytics are the drugs used more frequently for the pain. Antidiarrhoeals are administered to patients to whom diarrhoea is the main symptom during the resurgence of the symptoms. It is suggested to patients to whom constipation is the main symptom to consume, apart from the fibres, 8-10 glasses of liquidsand also to use mild cathartics. Antidepressants in low doses are administered to patients with serious pain when all the other regimens fail.