Irritable bowel syndrome is a dysfunction of the intestines, manifested by abdominal pain and / or defecation disorders. Irritable bowel syndrome develops as a result of psychological and other effects on the over-reacting bowel.
Irritable bowel syndrome is the most common disease of the internal organs. It can occur at any age, including in children. In women, the disease occurs 2-3 times more often.
Despite the extreme prevalence of irritable bowel syndrome, approximately 75% of the adult population do not consider themselves ill and do not seek medical help.
In the occurrence and development of the disease have psycho-emotional disorders.
The leading manifestations of irritable bowel syndrome are pain, abdominal discomfort and abnormal stool. Often in the feces you can see a large amount of mucus. A spasm of various parts of the intestine is observed non-permanently and may change localization on different days.
Patients with irritable bowel syndrome have many extra-intestinal symptoms, some of which are associated with dysfunction of other digestive organs, and the other with disorders of the nervous system and psychological status. The latter cause rapid fatigue, weakness, headaches, decreased appetite, sleep disturbances , palpitations, sweating, “lack of air” attacks, frequent urination, a slight increase in temperature, etc.
In irritable bowel syndrome, there is often a shortage of body weight, but it is not associated with impaired digestion of nutrients, but with features of neuropsychological status or with poor appetite.
High-quality eating disorders are manifested by dryness and flaking of the skin, a change in its color (a peculiar dirty-gray tint), the appearance of pigment spots on the face, hands and legs.
There are three main types of irritable bowel syndrome: with a predominance constipation , with a predominance of diarrhea and with a predominance of pain.
Abdominal pain, diarrhea, constipation, flatulence, bloating …
All these symptoms can be a single problem – irritable bowels. If the symptoms change the usual rhythm of a person’s life, it may help ….
The diagnosis of irritable bowel syndrome can be made on the basis of typical manifestations in the absence of other bowel diseases, which are excluded during additional studies.
At present, the “Roman criteria-II (2000)” is used to diagnose irritable bowel syndrome in adults: for at least 12 weeks (not necessarily following one after the other), in the last 12 months there is abdominal discomfort or pain, which have at least two of the following three characteristics:
- decrease after bowel movement;
- the onset is associated with a change in stool frequency;
- the beginning is associated with a change in the shape of the chair
Irritable bowel syndrome is diagnosed only if there is a connection between pain and discomfort in the abdomen with the stool. Pains appear in front of the stool and subside after bowel movements, and there is a dependence on changes in the regularity or consistency of the stool.
A number of signs not characteristic of irritable bowel syndrome, which may indicate the presence of other diseases.
- Rectal hemorrhage
- Weight loss
- Chronic diarrhea
- Onset of the disease in persons over 50 years
- Burdened heredity (cancer and inflammatory bowel disease in parents)
- The appearance of pain and diarrhea at night
Rectal bleeding can be due to hemorrhoids; decrease in body weight and low-grade fever – manifestations depressed or hypochondriac syndrome.
Treatment of irritable bowel syndrome should be comprehensive.
Diet for syndrome
With the prevalence of constipation shown diet with the addition of wheat bran.
In the case of the prevalence of diarrhea, it is recommended to limit foods rich in fiber (vegetables, fruits, bran).
Everyone, without exception, patients with irritable bowel syndrome are advised to follow an exception diet that does not contain caffeine, lactose, fructose, sorbitol, vinegar, alcohol, pepper, smoked foods, as well as products that cause excessive gas formation – milk, fermented milk products.
Correction of psycho-emotional disorders
The complex of measures aimed at improving the functions of the central nervous system and the correction of autonomic disorders includes psychotropic drugs, rational psychotherapy. In an optimal way, a psycho-neurologist or psychotherapist should be engaged in the diagnosis of psycho-emotional disorders and their elimination.
Antibacterial and bacterial drugs
Indications for the use of antibacterial drugs for irritable bowel syndrome are diarrhea, flatulence and abdominal pain.
Apply antibacterial drugs courses of 7-10-14 days. Recommended
- metronidazole ( trihopol ),
- as well as intrix, nitroxoline and nevigramone.
After antibacterial therapy, long-term (up to 1.5-2 months) administration of bacterial preparations (probiotics) is recommended: bifidum – and lactobacterin, bifiform, hilaka -forte, etc.
With diarrhea, imodium ( loperamide ) and alosetron have an effect.
With the prevalence of constipation shown tsuercal and motilium .
With persistent pain, Ditsetel and Duspatalin ( Mebeverin ) have a good effect .
All patients with irritable bowel syndrome with exacerbation of diarrhea prescribe astringent drugs: smectu , dermatol , tanalbin , white clay, as well as decoctions of herbs of similar action (chamomile, peppermint, St. John’s wort, alder cones, blueberries and bird cherry). With the same purpose, you can use some antacid drugs ( almagel , phosphalugel , maalox) and preparations containing bismuth ( venter ).
In irritable bowel syndrome with a predominance of constipation, it is necessary to develop a lost morning reflex to defecation and an increase in the amount of dietary fiber in the diet by introducing wheat bran into it. To stimulate defecation at the first stage of the development of a lost reflex,dufalac (lactulose), 1-2 teaspoonful spoons, should be administered overnight . Train yourself to empty your bowels every morning.
The condition of patients with irritable bowel syndrome, the effectiveness of treatment and the prognosis largely depend on the severity of related disorders of the nervous system. In achieving recovery, it is often crucial to overcome the conflicts that cause the formation of neurosis in a patient.
The working capacity of patients with irritable bowel syndrome and the prognosis for this disease largely depend on the severity of concomitant psycho-emotional disorders.