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Irritable Bowel Syndrome- Introduction

Irritable bowel syndrome, IBS or spastic colon is a medical condition characterized by regular episodes of abdominal pain, discomfort, sensation of bloating, altered bowel habits etc. Irritable bowel syndrome is considered as a variety of functional gastrointestinal disorder (FGID). Although the irritable bowel syndrome produces bothersome symptoms in contrast to inflammatory bowel disease (which includes ulcerative colitis and Crohn’s disease) this disease does not lead to damage to the bowel tissue or does not increase the risk of colon cancer in future.As such there is no permanent cure available for irritable bowel syndrome but symptoms can be managed successfully by making adjustments in the diet, prescription of certain drugs like anti diarrheal drugs, anticholinergics , antispasmodic agents, antidepressant agents, antibiotics etc and psychological interventions like counseling.

There several clinical situations which initially may lead to symptoms similar to irritable bowel syndrome.  These clinical conditions include celiac disease, fructose malabsorption, giardiasis, bile acid malabsorption, inflammatory bowel diseases etc. Although unlike most of the above mentioned clinical conditions irritable bowel syndrome does not lead to any damage to the gut wall and also the exact underlying cause is not known. However there are two possible explanations regarding the etiology of irritable bowel syndrome; these are deviation from the normal interaction between the brain and the digestive tract and abnormality in the normal gut flora leading to inflammatory changes and irritable bowel syndrome. Irritable bowel syndrome is more common in women and also being abused sexually earlier is also an important factor associated with the causation of irritable bowel syndrome.

Symptoms
There are several varieties of irritable bowels syndrome depending upon the predominant presenting symptoms. These include diarrhea predominant (IBS-D), constipation predominant (IBS-C), irritable bowel syndrome with alteration in bowel movement (IBS-A) and pain predominant Irritable bowel syndrome.In some of the affected patients the symptoms of irritable bowel syndrome may arise suddenly following episodes of gastrointestinal infections as characterized by fever, vomiting, diarrhea, positive stool culture indicating presence of specific infection etc. This type of irritable bowl syndrome (IBS –P) is termed as post infectious irritable bowel syndrome.

Usually patients of irritable bowel syndrome presents with very common bowel symptoms as caused by other common abdominal conditions. the most common presenting symptoms are pain or cramps in the abdomen, bloating, increased abdominal gas production, passage of loose (diarrhea) or hard stool (constipation), presence of mucous in the stool etc.The severity and duration of the symptoms vary from person to person; with time in some the symptoms become worse and improve in others even the symptoms may completely disappear.Alteration in the bowel movement in the affected persons of irritable bowel syndrome may lead to aggravation of the symptoms of piles, if already present. The patient may become malnourished either because of eating a particular type of food in the diet or due to inadequate absorption of nutrients through the gut wall.

As such irritable bowel disease may not lead to any other pathological conditions like cancer of the digestive tract in the future or permanent damage to the gut wall; however there is high chance that the social and family life of the person will be affected due to the bothersome symptoms of the disease.Studies have estimated that about 60% of the patients of irritable bowel syndrome suffer from some psychiatric problem namely depression and anxiety. Irritable bowel syndrome is quite common in the society leading increased loss of working days due to the severity and extent of the symptoms leading to loss of working days and increased economical burden on the affected person and on the society as well.

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