What is Irritable Bowel Syndrome IBS – 

also known as irritable colon?

• Irritable bowel

• Symptoms

• Causes and risk factors

• Examinations and diagnosis

• Treatment

• Course of the disease and prognosis

• Most common symptoms: Abdominal pain, diarrhea and/or constipation, bloating

• Possible causes: Disturbed barrier function of the intestinal wall, disturbed intestinal activity, increased immune activity in the intestinal wall, increased perception of pain

• Diagnosis: inflammatory bowel diseases, food intolerances, gastrointestinal infections, gynecological causes must be excluded for the diagnosis of irritable bowel syndrome (exclusion diagnoses)

• Treatment: always an individual treatment concept with medications, herbal remedies, homeopathics, probiotics, dietary changes, stress reduction.

• Irritable bowel syndrome: What's behind it?

• Abdominal pain, flatulence and diarrhea - where do the complaints come from and what helps against them?
  

• Abdominal pain, flatulence and diarrhea - where do the symptoms come from and what can be done about them? You can see that in this video.

In irritable bowel syndrome (irritable colon), intestinal function is disturbed. As a result, the stool changes: patients often suffer from diarrhea or constipation.

In some patients, however, bowel movements are unchanged. They mainly suffer from pain or flatulence, a bloated abdomen and outgoing bowel movements. These symptoms occur in combination with diarrhea and constipation.

Depending on which symptoms are prominent, irritable bowel syndrome is divided into five disease types:

1. Diarrhea type IBS-D

2. Constipation type IBS-C

3. Mixed Symptoms Type IBS-M

4. Pain type IBS-P

5. Bloating type IBS-P

In addition, one type of disease may also change into another or they may alternate. Diarrhea and constipation, for example, may even occur on the same day.

In all disease types, the following other irritable bowel symptoms are also common:

• Feeling of fullness

• Feeling that the bowel does not empty completely during bowel movements

• Mucus deposits on the stool

Abdominal pain is a major symptom of irritable bowel syndrome. The pain can occur in different parts of the abdomen and can be of different character, for example:

• burning or stabbing continuous pain

• more cramp-like pain in waves

• side stabbing-like pain

• dull pain, like a constant feeling of pressure in the lower abdomen

The abdominal pain in irritable bowel syndrome is caused on the one hand by the irritated intestinal mucosa, and on the other hand by the stretching of the intestinal wall due to increased gas formation. The intestinal muscles react to this with contractions.

Some sufferers notice an improvement in their symptoms when they are regularly active. Try to incorporate exercise into your daily routine, go for a walk, cycle or do gymnastics.

Every healthy digestive system produces gases in the intestines. In irritable bowel syndrome, however, they can form in excess due to disturbed intestinal movements and food utilization. This is particularly unpleasant for patients because their intestinal wall reacts more strongly than usual to the stretching stimulus caused by the gas bubbles. Cramp-like abdominal pain is often the result.

If the intestinal gas bubbles cannot escape sufficiently, a bloated abdomen forms, which can be distended like a drum and is painful.

Although the various symptoms usually improve after bowel movements, some irritable bowel patients find the bowel movements themselves painful.

In addition, many sufferers have the feeling that the bowels could not be emptied properly. This tempts some to use laxatives. However, such drugs then do not help and can aggravate the irritable condition. If laxatives are really necessary, they should be considered as a short-term solution because of the possible side effects.

Also common with irritable bowel syndrome is mucus buildup on the stool.

Regardless of whether patients with irritable bowel syndrome have diarrhea or constipation, they often suffer from a permanent feeling of fullness. This usually improves after bowel movements, but can also occur when those affected have not eaten any food at all and the bowel is relatively empty.

Risk of confusion with other diseases

The symptoms of irritable bowel syndrome are non-specific. That is, they also occur in a variety of other diseases. Before the diagnosis of irritable bowel syndrome is made, these must therefore be ruled out. Possible other causes for the complaints are

· Food intolerances, including to lactose, fructose, sorbitol or gluten

· Inflammatory bowel diseases such as ulcerative colitis or Crohn's disease

· Gastrointestinal infections

· Gynecological diseases, including ovarian cancer

The following symptoms are not typical irritable bowel symptoms. Rapid medical clarification is necessary in case of them, as potentially dangerous diseases may be behind them.

• Diarrhea that occurs mainly at night

• Fever (acute or chronic-recurring)

• Blood in the stool

• Severe unwanted weight loss

There are numerous hypotheses on the development of irritable bowel syndrome, but so far there is little reliable evidence.

However, scientists have been able to identify a whole series of typical changes in the intestines of those affected. These changes do not only occur in irritable bowel syndrome, but also in chronic inflammatory bowel diseases. These include:

It is thought that in irritable bowel syndrome, the natural movement of the bowel is disturbed. This means that the movements to transport the digested food do not run optimally.

Intestinal peristalsis is regulated by an independent nervous system with which the intestinal wall is equipped. This is also known as the "abdominal brain."

The abdominal brain senses when food enters the intestine and stretches the wall. Together with the neurotransmitter serotonin, the gut nervous system controls digestion. It stimulates the intestinal muscles to tense and relax alternately.

In irritable bowel syndrome, the nervous system gives incorrect instructions to the intestinal muscles. As a result, the muscles contract too quickly, too slowly or at the wrong moment, or they no longer relax properly. The food pulp is therefore transported too quickly in some patients. Then not enough water can be extracted from it in the large intestine. The result is diarrhea.

The opposite is also possible: If the muscles move too slowly, constipation can occur. Irritable bowel spasms, on the other hand, occur, among other things, when the muscles contract too strongly and for too long or do not relax properly at all.

As long as these tight junctions between the cells are intact, the intestinal mucosa cells as a whole form an effective barrier. It prevents foreign substances from entering the body uncontrollably from the intestinal tract.

In people with irritable bowel syndrome, these adhesion bridges break down faster than normal. As a result, the cells are no longer as tightly bound together, which weakens the barrier function of the intestinal mucosa. For example, foreign substances or pathogens can penetrate the intestinal mucosa more easily and trigger an immune reaction there.

Acute stress has been shown to lead to changes in the gastrointestinal tract. Gastric juice production increases, intestinal movements increase and the local immune response in the intestines changes.

However, people react highly differently to stress. While some sufferers have developed methods to deal with stress, others suffer enormously from the mental and physical consequences. Persistent life stress is important for the prognosis of the disease: patients with life stress show no improvement in their symptoms after six months. In contrast, 44 percent of patients without life stress show an improvement. The longer the medical history, the lower the chance of improvement.

Then talk to one of our Experts and let them guide you.

The right person to contact when irritable bowel syndrome is suspected is an internal medicine specialist who specializes in diseases of the digestive tract: a gastroenterologist. At your appointment, the doctor will first inquire about your current symptoms and any previous illnesses (medical history).

The doctor might ask you the following questions, for example:

· Where exactly do you have pain and in what situations does it occur?

· Do you have diarrhea or constipation?· Have you noticed a connection between the pain and certain foods?

· Are you currently in stressful circumstances?

· Have you noticed blood in your stool, do you have a fever, and have you lost weight unintentionally?

These would all be atypical of irritable bowel syndrome.

It is also useful to keep a 2-week stool diary (with at least one abnormal bowel movement) / food log and discuss the results with your doctor. In particular, this can often reveal a connection between certain foods and the symptoms. There are also special questionnaires for IBS.

The H2 breath test (also calles SIBO Breath Test) can be used to identify various carbohydrate intolerances.

To diagnose celiac disease, the blood is tested for certain antibodies and a tissue sample of the mucosa of the small intestine is analyzed under the microscope.

With the help of the Test, one can find out whether the barrier function of the intestine is disturbed (leaky gut syndrome).

• The patient suffers from chronic, i.e. at least one day per week, intestine-related complaints such as abdominal pain or flatulence, which are usually accompanied by changes in bowel movements such as diarrhea or constipation.
• Due to the complaints, the quality of life is significantly impaired.
• There are no changes characteristic of other clinical pictures that could explain the complaint

Then talk to one of our Experts and let them guide you.

Irritable bowel patients should therefore closely observe how their body reacts. It makes sense to record complaints as well as diet and other influencing factors such as stress and psychological strain in a kind of diary. This is the quickest way to become an expert on your own condition.

Always make changes to the therapy in small steps. With a little patience, you will find out the most sensible treatment strategy for you together with your doctor.

Tannins are released when black tea or oak bark tea is steeped for a long time before drinking. They can also be bought as capsules in pharmacies. They counteract inflammatory processes in the intestine, reduce secretion and slow down intestinal movement.

Loperamide is a synthetically produced substance distantly related to opium, but it acts almost exclusively locally on the intestine and immobilizes the overexcited intestinal muscles. As a result, the stool lingers longer in the colon, allowing more fluid to be extracted from it and making it firmer again. However, loperamide should only be taken for short periods of time and strictly according to dosage instructions, as the drug would otherwise lead to pronounced constipation.

Bile acid binders such as cholestyramine attach themselves to bile acids. and thus prevent their diarrhea-promoting effect. Since bile acids play an important role in fat digestion, the drugs also unfavorably hinder the absorption of fat-soluble vitamins (A, D, E, K) and medications.

Water-soluble dietary fibers such as psyllium, locust bean gum and pectin can also stop diarrhea. To compensate for fluid loss, increase fluid intake accordingly. In cases of severe diarrhea or if a child suffers from irritable bowel syndrome, electrolyte mixtures from the pharmacy may be useful.

If herbal medicines are not enough, the antispasmodic active ingredient butylscopolamine has proven effective. It is often used in combination with the painkiller paracetamol. Other active ingredients with antispasmodic effects are mebeverine or trospium chloride. Unlike the herbal preparations mentioned, however, these must not be used permanently.

· Bismuth oxide nitrate (Bismutum subnitricum).

· Cerium oxalicum· citron flower (Cina artemisia)

· Cyclamen (Cyclamen)

· Ginseng

· In addition: So called "Schuessler salt" - Kalium sulfuricum

The concept of homeopathy and its specific effectiveness are controversial in science and not clearly proven by studies.

As far as possible, the known stressors should be avoided. But this is not always possible. It is therefore important to learn how to deal with stressful situations and actively reduce stress. Targeted stress management, but also methods such as autogenic training, progressive muscle relaxation or yoga can help to prevent or alleviate the symptoms.

However, there is no universal recommendation for the diet of irritable bowel syndrome: different rules apply to diarrhea than to constipation. In addition, each affected person reacts differently to different foods.

Dietary tips for irritable bowel syndromeThe following basic dietary rules have proven helpful for some irritable bowel patients:

· Eat slowly.

· Don't gulp down a lot of air unnecessarily.

· Many small portions are better than a few large ones.

· Drink enough. Mineral water without carbonic acid, for example, is good.

· Fatty foods, legumes, strong spices, sometimes also coffee, alcohol, nicotine or dairy products can cause discomfort.

· Some people are also sensitive to white flour products, convenience foods and various sugar substitutes.

· Pay attention to how the food is composed and at what time of day you eat.

· Eat regularly and always at fixed times.· Do not eat too much, especially in the evening.

· Take your time for your meals, try to eat them in a calm atmosphere.

Abdominal massage

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal diseases in Europe. The disease often first appears between the ages of 20 and 30. Women are affected about twice as often as men.

Irritable bowel syndrome can vary greatly from person to person. The symptoms can also wax and wane, stop altogether, or recur. In some patients with irritable bowel syndrome, diarrhea, constipation, pain and flatulence alternate. Often, the disease significantly affects the quality of life.

If sufferers can find out what triggers their symptoms, they have a better prognosis. About 34 percent of patients succeed in alleviating their symptoms through targeted behavioral changes and therapeutic measures, or they even become completely symptom-free.

However, if irritable bowel syndrome persists for a long time, the prognosis is usually worse. About every second person affected develops chronic irritable bowel syndrome and suffers from the symptoms for many years or even their entire life. There is as yet no treatment that can completely cure the disease. However, there is also no evidence that irritable bowel syndrome causes other serious diseases.

Then talk to one of our Experts and let them guide you.