Irritable Bowel Syndrome
Comprehensive information on the causes, symptoms, and prognosis of abdominal pain and altered bowel function.
Symptoms and Causes
Irritable bowel syndrome is a chronic disorder that causes abdominal pain and leads to changes in bowel motility. Although it can affect any part of the gastrointestinal tract, it is most common in the colon.
Symptom intensity varies from one patient to another, but it frequently limits patient autonomy and significantly worsens quality of life if not properly managed. Although irritable bowel syndrome has no cure, discomfort can be reduced with certain lifestyle changes and personalized treatment.
Symptoms
The most characteristic symptoms of irritable bowel syndrome include:
- Abdominal pain: usually presenting as cramping that improves after defecation.
- Altered bowel habits: diarrhea or constipation.
- Changes in stool consistency.
- Abdominal distension.
- Flatulence: excess gas.
- Early satiety.
- Pyrosis: burning sensation in the throat or chest.
- Nausea.
- Incomplete evacuation.
Causes
The exact causes of irritable bowel syndrome are unknown, although it is believed to be related to one or more of the following factors:
- Intestinal contractions stronger than normal, which slow the passage of food.
- Alterations in the nerves of the digestive system, causing an exaggerated response to normal digestive processes.
- Severe gastrointestinal infections that may trigger bacterial overgrowth.
- Changes in the gut microbiota.
- Hormonal alterations.
- Food intolerances.
- Stress: although not the cause, it worsens symptoms.
Risk Factors
The most relevant risk factors for irritable bowel syndrome include:
- Sex: more frequent among women.
- Age: typically occurs between ages 35 and 60.
- Frequent stomach discomfort.
- Dysmenorrhea (painful menstruation).
- Bulimia.
- Depression.
- Family history, as the condition is believed to have a genetic component.
Complications
Contrary to what many people believe, irritable bowel syndrome does not increase the risk of cancer, as the intestinal tissue is not affected. However, changes in bowel transit commonly cause hemorrhoids or mood alterations derived from reduced quality of life.
Prevention
Irritable bowel syndrome cannot be prevented, but symptoms may be reduced by following these recommendations:
- Maintain a balanced diet.
- Avoid foods that may worsen discomfort: spicy foods, dairy products, citrus fruits, or gas-producing foods (legumes, cauliflower, cabbage).
- Avoid caffeine, alcohol, and soft drinks.
- Manage stress.
Which specialist treats irritable bowel syndrome?
Irritable bowel syndrome is diagnosed and treated in family and community medicine or gastroenterology.
Diagnosis
The diagnosis of irritable bowel syndrome is primarily clinical, as a detailed evaluation of symptoms along with the patient's medical history is usually sufficient. To confirm the diagnosis, the patient's condition is assessed according to the Rome criteria. The result is positive if, in addition to experiencing abdominal pain or discomfort at least one day per week for three months, it is associated with pain during defecation, pain linked to a change in bowel movement frequency, or pain linked to a change in stool consistency.
Additional tests are typically performed to rule out other conditions:
- Blood tests: help detect anemia or celiac disease.
- Fecal occult blood test: indicates bleeding somewhere in the digestive tract, polyps, hemorrhoids, or cancer.
- Stool culture: identifies infections if bacteria are present.
- Fecal calprotectin test: excess protein in the stool is a sign of intestinal inflammation.
- Colonoscopy: a probe is inserted through the anus to visualize the colon if cancer is suspected.
Treatment
The first step to alleviate irritable bowel syndrome symptoms is to modify certain lifestyle habits. In general, it is recommended to:
- Follow a balanced, fiber-rich diet.
- Limit the intake of spicy foods, acidic foods, dairy products, gas-producing foods, or excessively sweet products.
- Avoid alcohol, coffee, and soft drinks.
- Drink plenty of water.
- Avoid heavy meals.
- Take necessary measures to control stress.
- Engage in moderate physical activity regularly.
- Get adequate sleep.
In addition to lifestyle changes, medications may be used:
- Fiber supplements.
- Antidiarrheal agents.
- Laxatives.
- Probiotics: promote the proper growth of beneficial digestive bacteria.
- Antispasmodics: reduce intestinal spasms.
- Prokinetics: enhance intestinal motility.
- Antidepressants: in addition to improving mood, they relieve abdominal pain and reduce bloating. They are also effective in controlling diarrhea.
- Cognitive-behavioral therapy to modify patient behaviors.
