Abdominal pain the prime symptom of IBS

The prime symptom of IDS is abdominal pain, so this is the first and the most important symptom to consider. In fact, without being, it is actually not possible to make a firm diagnosis of irritable bowel syndrome. Many experiments being carried out on IBS sufferers and it has been found that in IBS patients there is something called visceral hypersensitivity, which simply means that the gut is more sensitive to pain in irritable bowel syndrome patients. Despite their sensitivity, the gut still appears to be quite healthy.

It has been suggested that because the gut appears healthy, that the cause of the pain is not in the gut at all but in the brain. Perhaps in IBS, the stresses and strains of modern life can lead to increased sensitivity in the brain itself, which may lead to pain signals in IBS patients. Another explanation may be that there are simply more signals coming from the gut to the brain. These theories have yet to be confirmed by research. IBS patients can find it very frustrating when the doctor can’t seem to determine the source of the abdominal pain, as a painful abdominal region is difficult to identify. For a doctor to correctly identify the cause of the pain it is important to know not just where the pain comes from but also when it comes, and also whether it follows certain activities such as eating meals or physical exertion. It is also crucial to discover any factors that may make the pain better or worse, such as deep breathing, or a change in posture. In IBS sufferers the whole gut is a potential source of pain and more than one site can be involved in any individual patient. It is therefore more important when diagnosing IBS to consider the nature of the pain itself rather than where the pain is coming from.

A good doctor will of course ask all these questions when trying to identify the patients problem. Prior to visiting your doctor it makes sense to think about the nature of your pain so you can provide accurate answers, questions your doctor may ask include:-

• Where is the pain felt?
• Where does the pain spread to?
• When does the pain come on?
• What makes the pain better, can you do anything to relieve the pain?
• Does anything make the pain worse?

IBS pain normally occurs across the belly and below the navel, but as discussed can arise anywhere in the abdominal area. It is often associated with bloating and can often occur when you start eating. In women, it is common for this abdominal pain to be worse in the days leading up to the periods. Characteristically this pain is relieved to some degree by passing wind or a stool.

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• Ouch, my stomach hurts (blisstree.com)

Constipation as a cause of IBS

Constipation is a major problem in the Western world with millions of dollars being spent each year on laxatives. It is obviously a major medical problem and believe it or not there is still considerable disagreements as to exactly what the term constipation actually means. For some, constipation simply means going to the toilet less frequently, some doctors have suggested that a practical definition of constipation should be the passage of less than three stools per week.

If we follow the definition of constipation as less than three bowel movements per week + 2 or more of the following symptoms for at least 12 weeks in 12 months;

• Straining
• lumpy or hard stools
• sensation of incomplete evacuation
• sensation of blockage of the bowels
• manually assisting bowel evacuation

Surprisingly, urgent diarrhoea may be the result of underlying constipation and treatment of this diarrhoea with anti-diarrhoea drugs will obviously only make the problem worse. In most cases of constipation and the extended bowel can actually be felt externally when the abdomen is examined. Scientifically, constipation is evaluated in two ways, firstly by measurement of the time it takes food to pass through the body (whole gut transit time) which in any case should be less than 70 hours, and by measuring the weight of the stool. To determine the actual TRANSIT time patients are asked to swallow special markers that show up on x-rays. A specific number of these markers are sold each day and then x-rays are taken at timed intervals to view the position in the intestine, from these measurements exact TRANSIT time as calculated. Faecal weighing simply involves collecting stools passed over a 24-hour period and winning them. The average time for the passage of undigested food residue through the guts is around 50 hours from men and 57 hours for women. But it can range from twenty to a hundred hours in many patients. Most of this transit time is spent passing along the large intestine.

Lumpy or hard stools are hard to pass and often require straining, whereas very loose or liquid stools can be too easy to pass and need reduce accidents, the ideal stool should be soft and sausage like in shape. Number 3 or 4 on scale shown below. The shape and type of stool is the easiest and most reliable indicator of whole gut transit time.

Related articles

• Bowel Problems ~ Symptoms Diagnosis by a Doctor (healthhype.com)
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What are the symptoms of IBS?

Symptoms of IBS
As the diagnosis and effective treatment of IBS are based entirely on symptoms, it is crucial that patients describe symptoms correctly, no matter how embarrassing they may be. IBS is a very common complaint nowadays and all the symptoms of IBS can be the result of a wide range of differing problems. Doctors use the term chronic to describe symptoms that are persistent and long-lasting. It is important to distinguish chronic symptoms from those symptoms that may occur suddenly and a short lived. It is important that patients describe symptoms correctly and differentiate between chronic and normal symptoms. Many patients believe chronic pain to be pain that is particularly severe as opposed to pain that is persistent and long-lasting. If such terms are misunderstood it can lead to problems with diagnosis.

In summary irritable bowel syndrome symptoms are not all in the mind and can all be treated to some extent. A little bowel syndrome is not a dangerous disease but it can have serious implications on your quality of life. IBS is essentially involves persistent pain in the abdomen which no other cause can be found. IBS symptoms can include diarrhoea, constipation and abdominal bloating.

It is vital to be accurate about your symptoms so that you can give your doctor and accurate description. The questions that you will need to answer include:

• Where exactly do you feel the abdominal pain?
• When you do feel abdominal pain what makes it feel worse, or better?
• How often do you need to go to the lavatory?
• Do you ever have to rush to the lavatory for fear of having an accident?
• When on the lavatory do you strain to pass anything at all?
• What do your stools look like? (This will entail examining your stools on a regular basis)

The answers to the above questions will help to confirm or deny symptoms of IBS, remember not all bowel/digestion issues mean IBS!

Malfermentation and IBS

The modern-day diets tend to contain lots of highly processed convenience foods that are often low in fibre. Fibre can be found in whole grains, bread, vegetables, pulses such as beans and lentils and peas, nuts, seeds and fruits. Fibre has an important role in absorbing fluid from the gut which produces soft stools that are easy to pass. Fibre also has other benefits such as reducing the absorption of cholesterol, reducing the risk of gallstones and helping to prevent piles.

We all there is little doubt that high fibre diets can be helpful for IBS sufferers, for some the high-fibre will create more wind, bloating and diarrhoea. The foods that tend to make wins and bloating words are dried fruits and nuts, baked beans and vegetables such as broccoli, cabbage or cauliflower. Fizzy drinks such as cola and beer can also increase wind.

Reducing bacterial activity in the bowel has been shown to help many patients. This was first realised when some patients found their IBS symptoms temporarily improved after a course of antibiotics prescribed for an infection. This suggests that bacteria in the gut can be a cause of IBS symptoms.

If you are an IBS sufferer there are basically two forms of diets that will help to reduce malfermentation. One is that all fibre diets and the other is the exclusion diet. The law fibre diets is probably the most straightforward diets for the treatment of IBS. For this reason it is normally the first diets recommended by doctors. The exclusion diets will help to find out whether you have any specific food intolerance is although it can be difficult to pinpoint the individual foods that are causing the problems. There are some foods that are more likely to be responsible for IBS symptoms than others, however the only be to decide which foods cause your symptoms is to test them individually. Before starting any diets always discuss it with your doctor. Common foods that have proven to be the source of the problems in many patients, including beef, potatoes, citrus fruits, wheat, daily products, fizzy drinks and yeasts.

Gluten is the protein found in meat and other cereals. Many people suffer from a gluten intolerance to various degrees (some patients may not even be aware of this intolerance). And in free diets will involve avoiding wheat, rye and barley, and all products containing them.

Related articles

• Dietary Treatment for IBS (dietriffic.com)
• Irritable Bowel Syndrome Around the Web (fightingfatigue.org)
• Interstitial Cystitis & IBS Around the Web (fightingfatigue.org)
• What Is IBS (Spastic Colon) – Symptoms, Proper Diet, Coping With Stress (healthhype.com)

Which sort of IBS do you have?

You may be forgiven for thinking that IBS is unlike other medical conditions under some sort of bizarre process which will never be understood or successfully treated by man. This is simply wrong. IBS is no different from any other disorder, and can be managed and treated according to the same principles. It is necessary to find the cause of the problem and then simply deal with it in a logical way. This is not always easy however as the causes of IBS can be greatly. Drug companies spend millions of dollars every year on developing treatments for IBS, but as yet no drug has been discovered that will be effective in every case of IBS and sadly there probably never will be.

Many doctors do not yet understand the difference between one form of IBS and another. This of course is a recipe for failure, as if you don’t realise the precise cause you can never recommend the precise treatments. Some cases of IBS respond very well to changes in diet (such as changing to more and bulk laxatives or perhaps excluding certain food trips). As in other cases IBS is clearly associated with anxiety symptoms. In some patients the abdominal pain symptoms of IBS I’m not even related to the bowel at all, but come from pressure on the nerves of the spine that supply the abdominal wall.

Some doctors classify IBS by dividing patients into 3 groups. Group 1 is free of the abdominal pain is accompanied by diarrhoea, a second trip via the pain is associated with constipation, and the third group with the abdominal pain can be associated with both baby and constipation.

Broadly speaking, patients suffering with diarrhoea and winds generally respond well to dietary help. Patients with constipation respond well to added fibre, whereas patients with constipation associated with winds respond best to a low fibre diet and bulk laxatives. Dietary changes will have a major impact on IBS symptoms for around 60 to 70% of patients.

The crucial question in managing your IBS is deciding on your predominant stool habits. It is necessary to record your stool puttering cheerfully for up to 10 days or more, to determine the possible causes of your IBS. Stools can be classified according to the Bristol stool form scale as follows;

• Type one stools for separate hard lumps like nuts
• Type two stools are sausage shaped but lumpy
• Type three stools are sausage like but with cracks on the surface
• Type four stools are sausage or sneak like, smooth surfaced
• Type five stools are soft blobs with clear-cut edges
• Type six stools are fluffy with the ragged edges
• Type seven stools are watery with no solid pieces, entirely liquid

The ideal stools are types three and four, especially type 4.

Nausea and vomiting really over in IBS patients. With the exception of those IBS patients or the cause is thought to be anxiety where air swallowing can distend the stomach.

Further reading:

• What Is IBS (Spastic Colon) – Symptoms, Proper Diet, Coping With Stress (healthhype.com)
• Causes of Chronic (Prolonged, Persistent, Constant) Diarrhea (healthhype.com)
• Interstitial Cystitis & IBS Around the Web (fightingfatigue.org)

Diagnosis of IBS

IBS diagnosis really depends on the discussion of symptoms with your doctor. There is no characteristic symptom pattern that accurately confirms IBS. The diagnosis is based completely on the patient/Doctor consultation and other relevant details such as the medical history.

Because there is no single test that definitely confirms IBS the diagnosis is far from straightforward. For some doctors the definition of IBS is simply any abdominal pain for which no other cause can be discovered. Doctors may check patient’s history, analyse their blood and stools, and even test the urine, only to discover that all tests are completely normal. In some cases endoscopy (an internal examination of the bowel using a viewing device) may also be performed with no abnormalities being discovered.

Because the diagnosis of IBS is classified by symptoms rather than a complete understanding of the cause, IBS is given the label of a syndrome.

There is a criteria that has been established by a group of medical specialists at a meeting in Rome which is used by doctors as an aid to the diagnosis of IBS. However even this criteria cannot reliably distinguish between IBS and other colon diseases such as Crohn’s disease or colitis.

Please find details of this Rome criteria shown below;

Patients must have suffered abdominal discomfort or pain for at least 12 weeks with two of the following three features – pain relieved by defecation, onset of pain associated with a change in the frequency of stool, or onset of pain associated with a change in the form or appearance of stool.

The following symptoms are not normally seen in IBS and must always be investigated further;

Weight loss
blood in stools
abdominal pain or diarrhoea during the nights
anaemia
Fever

In summary, IBS symptoms are not on the minds and can be successfully treated, the diagnosis of IBS does not mean that you suffer from a dangerous condition but it can have a serious impact on the quality of your life. Essentially IBS involves pain in the abdomen which no other cause can be found. The may also be diarrhoea and or constipation with abdominal bloating. In all cases if you have any of these symptoms it is imperative you to your doctor for advice and to rule out more dangerous conditions.

Related articles

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Confusion around IBS

Irritable bowel syndrome (IBS), is an ailment involving the bowels or intestines, in particular the colon or large bowel. IBS can be difficult to diagnose correctly as the major symptoms which includes, diarrhoea, bloating, abdominal pain and constipation are quite common complaints in the modern world.

These symptoms can also be the result of many other conditions, including bowel cancer. If you regularly experience any of these symptoms you should see your doctor as a precaution for the following medical checks, kidney function tests, thyroid function tests, liver function tests, tests for inflammation and examination of faeces for bacteria and parasites. For patients over the age of 45, it is advisable to have a large bowel examination by x-ray or colonoscopy to exclude cancer.

In the old days, many doctors believe that that IBS was simply a physcosomatic disease, caused by anxiety, depression or panic. The reason for this belief was the fact that no signs of disease could be found in the bowel to explain the symptoms. Nowadays, although it is known that psychological factors can affect IBS, this disease is no longer dismissed as largely all in the mind.

Many people still shoe that as no serious disease is found in the barrels that IBS is a trivial problem. This is far from the truth, although IBS is not a dangerous disease the effects and symptoms can be devastating for the patient.

The abdominal pain of irritable bowel syndrome can be most severe and have serious impacts on the patient’s everyday life. IBS is certainly not a minor problem in fact it is the commonest reason for referral to gastroenterology department’s worldwide. For example the annual costs of IBS in the UK alone are estimated at £46 million and in the USA over $1.6 billion!

If you believe you me have IBS you should visit your doctor to check that you are indeed suffering from IBS and get advice on any medication which may help the symptoms.

Related articles

• IBS Around the Web (fightingfatigue.org)
• What Is IBS (Spastic Colon) – Symptoms, Proper Diet, Coping With Stress (healthhype.com)
• Interstitial Cystitis & IBS Around the Web (fightingfatigue.org)
• Bowel Problems ~ Symptoms Diagnosis by a Doctor (healthhype.com)
• Causes of Chronic (Prolonged, Persistent, Constant) Diarrhea (healthhype.com)