Irritable Bowel Syndrome (IBS) Causes and symptoms

Irritable Bowel Syndrome or IBS is a common functional gastrointestinal disorder in which there is an absence of any structural pathology, as nothing is obtained from any investigatory procedures like endoscopy, colonoscopy, etc.

Irritable Bowel Syndrome (IBS) is a disorder of the young age group, mostly present before the age of 45 years, but some reports suggesting that elderly persons are also suffering from this disorder. This disorder is found 3 times more in females as compared to the male population.

Causes of Irritable Bowel Syndrome (IBS):

A large number of patients develops the symptoms of Irritable Bowel Syndrome in response below factors:

1. Luminal factors: Patients develop symptoms of IBS after they suffered from gastroenteritis, it is more commonly found in women of young age and in those persons who are living with psychological problems, some of these are unable to tolerate some specific dietary components like wheat and lactose. It is also assumed that some abnormalities of the gut microflora, which causes increased production of gas and the process of fermentation and a small amount of inflammation.
2. Psychological factors: About fifty percent of patients suffering from Irritable Bowel Syndrome (IBS) have disturbances like neurosis, anxiety, depression, panic attacks. Apparent psychiatric disease and psychological stress are responsible to alter gastrointestinal motility and visceral perception in the patients suffering from Irritable Bowel Syndrome (IBS) even in healthy individuals.
3. Disturbance in gastrointestinal motility.
4. Visceral hypersensitivity or Abnormal visceral perception.

Criteria for the diagnosis of Irritable Bowel Syndrome (IBS):

Minimum 12 weeks (may or may not be continuous), in the past 12 months of discomfort in the abdomen or with pain in the stomach that has at least two of the following three features:

1. Abdominal discomfort or pain in the abdomen relieved by the defecation.
2. The onset of abdominal discomfort or pain in the abdomen, associated with a change in frequency of stool.
3. The onset of abdominal discomfort or pain in the abdomen, associated with changes in stool form.

Symptoms of Irritable Bowel Syndrome:

Most patients present with the complaint of pain in the abdomen which is associated with the alteration in bowel habit (means a change in frequency of passing of stool or the consistency of stool), which consists of diarrhea and constipation alone or with both.

In some patients, there is painless diarrhea, but this feature of painless diarrhea did not fulfill the criteria for the diagnosis of this disorder.

Abdominal pain: Prerequisite symptom, it varies in location and its intensity, it is episodic and crampy in nature, it may be mild and that’s why many times it is ignored by the patients. Abdominal pain is mainly present in waking time only, but the patients who are suffering from severe IBS, often awake at night due to pain in the abdomen, but sometimes it may be due to some other cause. Pain in the abdomen gets worse by emotional stress or by eating and it is relived after passing stool or flatus. In females who are suffering from Irritable Bowel Syndrome (IBS) have their worst pain in the abdomen during their menstrual and premenstrual phase.

Gas and flatulence: Complaint of distention of the abdomen and increase in belching or flatulence is frequently found in the patients suffering from Irritable Bowel Syndrome (IBS).

Altered bowel habits: It is the most basic feature found in IBS, it starts in the adult age group, commonly found pattern is constipation which alternates with diarrhea, at the initial stage constipation is episodic and after some time it becomes continuous and requires treatment with laxatives (medicines which help to pass stool softly ). Many patients complain of incomplete passing of stool they feel that that they have pass more stool but not passed, that’s why they attempt to defecate in a short time frame. Patients who have constipation as the main symptoms may have a short period of diarrhea also, which is characteristical of the low volume of stools.

Diarrhea in Irritable Bowel Syndrome is absent at night. Diarrohea aggravated by eating or emotional stress, sometimes a large amount of mucus is also present in the stool so erroneously called mucous colitis.

Nearly half the patients also complain of nausea, vomiting, heartburn, etc. Bleeding is not found in Irritable Bowel Syndrome unless hemorrhoids are present, also weight loss does not occur.

What to eat in Irritable bowel syndrome:

Target is to make a balance between symptoms of diarrhoea and constipation in Irritable bowel syndrome so,a balance between high and low fiber diet is required.

1. High fiber diet
   1. Pulses, soybeans, strawberries, Grapefruit, almonds, brazil nuts, walnuts, pine nuts, pecan, flax seeds, dill seeds, chia seeds, sunflower, and pumpkin seeds, etc. Oatmeal to be preferred and must avoid fibers from grains helps to avoid constipation.
   2. Soluble fibers found in
      1. Low-FODMAP Vegetables
         1. Broccoli.
         2. Carrots.
         3. Potato, tomato, bamboo shoots.
         4. Fennel, ginger, bell pepper, sweet potato, parsnip, green beans, turnip, water chestnut, etc.
      2. Low-FODMAP Fruits
         1. Avocado, Banana, Blueberries, Raspberry, Strawberry,
         2. Kiwi, lemon, orange, honeydew melon, grapes, olive, mandarin orange, pineapple, papaya.
2. Low-FODMAP Green vegetables to be promoted in Irritable bowel syndrome, like Swiss chard, kale, collard greens, Lettuce, bok choy, etc.
3. Low-FODMAP cooking oils to be used in Irritable bowel syndrome: Olive oil, avocado oil, rice bran oil, coconut oil, rice bran oil, peanut oil, sunflower oil.
4. Kefir, fermented vegetables like sauerkraut and kimchi can be taken in Irritable bowel syndrome.
5. Tofu, chicken(leg is to be preferred not chicken breast), fish, eggs can be taken.
6. Try fruit without skin.
7. Aged cheese is good.
8. A gluten-free diet must be promoted in Irritable bowel syndrome.
9. Must avoid chocolate, coffee, and fibers which are insoluble in water.
10. A low-fat diet, to be promoted, so avoid red meat, animal fat, and fried foods and promote lean meat, fruits, vegetables, low-fat dairy products, rice milk, almond milk, coconut milk, soy milk, etc and soy cheese can be preferred.
11. Lactose rich things to be avoided or to be reduced in Irritable bowel syndrome: Cottage cheese, ricotta cheese, cow milk, ice cream, pudding, yogurt (lactose-free can be taken).
12. Fructans rich food to be avoided or to be reduced: Asparagus, garlic, onion, artichokes, brussels sprouts, apples.
13. To avoid are legumes, bran fiber, refined grains, cashews, pistachios, artificial sweeteners like products with high fructose corn syrup, honey, and agave nectar, cauliflower, processed foods, caffeinated energy drinks, soda, legumes, beans, fried food, peaches, mango, apple, cherries, watermelon, pear, mushrooms, wheat, and rye.
14. Check for individual food substances which trigger the symptoms in an individual.

Treatment & Home Remedies for Irritable Bowel Syndrome :

1. Homeopathic medicines give prompt improvements in the symptoms.
2. Avoiding the food substance which aggravates the symptoms in the patients given in the above section.
3. Avoid stress, exercise.
4. Peppermint tea, anise tea, green tea, they have the power to reduce pain and gas in the abdomen.
5. Banana helps to control diarrhea.
6. Fennel (not more than one teaspoon), asafoetida, and ginger reduce gas and cramps in the abdomen.
7. Cabbage Juice, castor oil helps in constipation, it passes stool softly.
8. Apple cider vinegar is good for diarrhea.