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Irritable bowel syndrome

To meet a person who would not faced with the discomfort arising from disorders of bowel function, is almost impossible. It could be such a condition of the digestive system that cause constipation, diarrhea, colic, flatulence. In any case, this definitely affect your normal rhythm of life, breaking it. The reason for the development failures of the intestine are not always bacterial agents that cause infection or disease of the digestive tract of organic nature.

Available statistics clearly indicate that in 30% of cases the fault of all disorders of the small intestine and colon is a functional disorder of physical activity. These violations are called in medicine, common term for irritable bowel syndrome.

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What is irritable bowel syndrome?

Irritable bowel syndrome is a recurrent disorder of stool, accompanied by painful sensations in the absence of other precipitating causes. Such causes can be fungal, bacterial or viral infection of the gut, its immune inflammation, colonization of the protozoan organisms, or helminths, presence of tumors, congenital anomalies of anatomical development. All laboratory tests in humans must be normal, absent any changes in rates of blood and feces.

With regard to the question of prevalence among male and female population from this problem more often affects women. They are prone to irritable bowel syndrome in 15-25% of cases, and men in 5-15% of cases. Often, people after the age of 20 years, the peak incidence among them are 35-50 years old. About 40% of people with symptoms areit is in this age range.

Qualified help at least 40% of patients, of these, only 28% go with his problem to gastroenterologists and 12% for General practitioners.


Causes of irritable bowel syndrome

To identify any one reason why developing irregularities in the functioning on the gastrointestinal tract is impossible. However, scientists have identified the most likely causes of irritable bowel syndrome, including:

  • Stress. It was found that problems with the intestine of an appropriate nature occur most often on the background of instability and excessive excitability of the nervous system. A particular danger in this regard are chronic stress. The same reason explains the fact that among cases mostly women, and young age.

    Most often it creates a vicious circle: there is an adverse emotional background, it entails stress, stress contributes to irritable bowel, problems with the organ of the digestive system cause a person to become depressed, this affects other systems and organs. So often in people suffering from irritable bowel syndrome, doctor-neuropsychiatrist reveals the various neuroses and personality disorders.

    Among the representatives of the medicine, even there is a joke: instead of the term "irritable bowel syndrome", they use the term "syndrome razrezhennoi head." This is due to the fact that in parallel with the violations in the digestive tract, there are problems with the Central nervous system and autonomic regulation.

  • Violation of motor activity of the intestine. The syndrome may be due to impaired motor activity of the intestine, a failure in conduction between the intestinal muscles nerve impulses, which causes the organ of digestion to decrease. In this case, fails to detect any abnormalities in the functioning of the nervous apparatus of the intestine, or the intestinal wall. Occur with uncertain frequency relaxation and reduction occur by themselves.

  • Such people often suffer from feelings of fullness and stretching of the intestine, the threshold of their pain sensitivity increased.
  • You can also establish some relationship between hormonal fluctuations in the body and relapses of pathological symptoms. Often, women say that in the last and the first day of the next menstrual cycle they have diarrhea, increased intestinal pains. Doctors attribute this increase in the blood concentration of prostaglandin E.
  • Intestinal upset may occur dueadding overly fatty foods having high calorie content. However, not only food, but beverages can cause discomfort. The greatest danger in this regard are: coffee and tea, alcohol and sweet soda water.
  • Do not forget about the hereditary predisposition to such disorders. If irritable bowel syndrome was diagnosed in parents with a high probability it will bother children.
  • Transferred intestinal infections can cause IBS. It's about 30% of all people with typical disorders.
  • The lack of ballast substances, which activate the production of digestive enzymes and bacterial overgrowth – all these States can act as causes of irritable bowel syndrome.

Symptoms and signs of irritable bowel syndrome

The symptoms of irritable bowel syndrome have a direct similarity with the ordinary intestinal disorders.

There are several possible variants of the course of disease with a characteristic for each of these features:

  1. Irritable bowel syndrome type diarrhea. The urge to empty the bowel occurs or immediately after a meal or during the act of eating. Such discomfort a person may experience several times throughout the day. This occurs most often in the morning or in the afternoon.

    • Diarrhea is often accompanied by emotional excitement, fear, and the experience. In the vernacular you hear a term such as irritable bowel characterizing such a state. The analogy made in this forest resident is not just. He responds to danger or fear an act of involuntary defecation. (see also:the Symptoms, the color and the causes of diarrhea.)

    • Expressed bloating, soreness, lokalizirutesa in the right and left side and below the navel are all symptoms that accompany the sudden urge to empty the bowel. After visiting the toilet room, the person experiences marked relief.

  2. Irritable bowels on the type of constipation. Constipation can occur for more than 3 days. This person will also experience a feeling of bloating, pain in the characteristic area. Sometimes pain occur type cramps, sometimes they are aching in nature.When the chair allowed a few pain lessen, but do not pass completely. The chair resembles the form of sheep feces with a white or transparent mucous impurities.

    Because of the prolonged inability to empty the intestines, the person suffers from appetite, it can haunt heartburn or nausea, mouth an unpleasant taste. (see also:Constipation - causes, symptoms and treatment)

  3. Irritable bowel syndrome with a change of constipation and diarrhea. To the fore in this case, go painful. Constipation and diarrhoea alternate with each other.

Summing up, it can be noted that irritable bowel syndrome is accompanied by the following signs:

  • Variability disorders chair with a predominance of either constipation or diarrhea or alternating.
  • Abdominal pain, which tend to decrease after a bowel movement.
  • The resulting feeling of the impossibility of containment of feces.
  • Flatulence, accompanied by severe bloating.
  • Mucus in the stool.
  • The feeling of incomplete emptying of the bowel after going to the toilet.

Diagnosis of IBS

The diagnosis of "irritable bowel syndrome" is for doctors with a certain difficulty, as the indicators of blood tests, and stool, x-ray examination and biopsy of the human remains in the normal range. So in Rome, a conference was held, which was clearly identified criteria to diagnose irritable bowel syndrome.

Signs of this disease is considered to be: pain and discomfort in the intestines for 3 days in a month. The duration of the occurrence of such pain six months or more. After defecation the person needs to be relieved. Change the look of the chair and its shape was supposed to happen at the moment when the patient first noted in his pain.

Additional criteria that help to clarify diagnosis are:

  • The acts of defecation and learning happen more than 3 times in 24 hours, or reduced and less likely to happen 3 times in 7 days. That is, the person suffers from constipation or diarrhea.
  • The chair changes shape: it becomes liquid with foam or hard and rough.
  • Defecation either difficult, or the urge impossible to hold back.

An important differential diagnosis, allowing to differentiate irritable bowel syndrome from other more serious pathologies of the body. Itso the patient with symptoms should be sent to delivery the following tests:

  • General analysis of blood;
  • Biochemical analysis of blood;
  • The coprogram;
  • According to the testimony undergo a barium enema or sigmoidoscopy;
  • If necessary, a biopsy of the bowel wall.

It is established that the majority of patients – namely, 90% of people after treatment by the doctor and the diagnosis of IBS on their own to cope with symptoms of disease and do not feel sick. However, the remaining 10% of people recognize themselves hopeless patients. They seek to pass new examinations, which do not show they have more or less serious diseases. However, people are even more convinced they have extremely severe disease and often for this reason socially isolated.

Differential diagnosis of IBS

Not always a problem with the act of defecation, and abdominal pain indicate just irritable bowel syndrome. Hence the importance of differential diagnostics, allowing to set symptoms for this syndrome is not peculiar.

Among them:

  • The manifestation of a pathological condition in the elderly;
  • The progression of the disease;
  • The presence of acute symptoms, it is important to remember IBS is a disease of a chronic discharge;
  • Signs of disorders in the intestines occur at night;
  • From the anus observed discharge with impurities blood;
  • Diarrhea is accompanied by painful sensations;
  • In the stool there are lipid inclusions (steatorrhea);
  • The body temperature rises;
  • There is an intolerance to gluten, lactose, fructose;
  • Close relatives was diagnosed with bowel cancer or other inflammation.

It is important to distinguish IBS from the following conditions, which will allow to avoid mistakes in diagnosis:

The causes of the disorders in the intestine related to the way of life

  • The intake of alcohol, foods causing flatulence, coffee;
  • Eating fatty foods;
  • Prior to the disorder of the feast;
  • Exotic food;
  • Iron supplementation or potassium, antibiotics, bile acids, misoprostol and other drugs;
  • Transferred stress, fright, and severe emotional distress (after rest symptoms should disappear).

Natural hormonal fluctuations in a woman's body

  • Premenstrual symptom;
  • Menopause;
  • The period of carrying a child.

Gynecological diseases

  • Endometriosis;
  • Scar plastic peritonitis.

Disease of the intestines organic

  • The presence of diverticula in the intestine;
  • The defeat of the intestine by Mycobacterium tuberculosis;
  • Colorectal cancer, or colon cancer;
  • Granulomatous enteritis;
  • Ulcerative colitis;
  • Microscopic colitis;
  • Polyp of the intestine;
  • Parasitic infection;
  • Pathological elongation of the sigmoid colon (dolichosigma);
  • The short bowel syndrome.

Gastrointestinal tumors of neuroendocrine origin

  • Syndrome Zollingerellison;
  • The initial stage of the carcinoid syndrome.

Pathology endocrine etiology

  • Thyrotoxicosis;
  • Diabetic enteropathy diabetes.


Treatments

The main goal of treatment is to remove the negative symptoms that worsen quality of human life. However, before resorting to conservative therapy, refer to the teachings of Pavlov and remember his theory, which boils down to what all diseases the roots grow out of the CNS disorders. It is in relation to the irritable bowel syndrome his teachings are very relevant. Practical medicine has proved that various activities aimed at achieving psychological comfort of the individual, will have a positive impact on the human condition with IBS.

So when periodically there are the symptoms of the disease but the man himself is not able to cope with chronic stress, problems insociety or within the family, should seek help from a qualified psychologist. When the background SRK developed a phobia of bowel or samarityanka depression, a psychiatrist and neurologist is mandatory.

When the condition is not aggravated, before resorting to medicamentous correction, you can try to adhere to the following guidelines:

  • To revise the way of life;
  • To establish the food;
  • To exclude tobacco and alcohol drinks;
  • Physical activity should be daily, but feasible;
  • Spend more time outdoors, just walking.

These simple tips are able to help to cope with the imbalance of the nervous system and to solve bowel problems when they "grow up" out of my head.

Diet

Regarding the transition to therapeutic food for irritable bowel syndrome, it is not required. However, to observe certain rules should still be. First and foremost, it is necessary to adjust the power. It should be a fraction and be in a relaxed environment.

Depending on what symptoms are predominant in humans with irritable bowel syndrome should follow the following guidelines:

  • If you have diarrhea you should avoid foods that stimulate intestinal motility. It's all vegetables and fruits with a tough, indigestible fiber, and apples, plums, beets.
  • For constipation, you should refrain from fried and oily food.
  • When excessive flatulence should not be too much to consume legumes, grapes, pastry, cabbage, nuts.

If a person knows that they have a lactose intolerance, you should exclude from my diet milk. It successfully replaces kefir, fermented baked milk, yogurt.

If you have celiac disease, it is necessary to completely give up foods containing gluten.

In addition, you need to minimize the consumption of carbonated drinks and chewing gum. For normalization of the intestinal microflora will help course admission Linex.

If IBS is accompanied by diarrhea

When the chair can not be adjusted in a more gentle manner, painful sensations are accompanied by diarrhea, it is necessary to resort to more radical methods of struggle with the disease. However, do not own to stop the diarrhea medicines, as often it becomes the cause of food infection. Therefore, prescribed drugs should gastroenterologist.

In addition, continuous intake of medicines in irritable bowel syndrome can be dangerous.

Drugs are prescribed exclusively on the exacerbations of this chronic illness:

  • Up to three times a day before meals you can take one tablet Diphenoxylate or Loperamide (Loperamide, Lopedium, DIARA, Imodium cost of these drugs from 20 to 250 rubles). These funds help to slow bowel motility.
  • To resolve diarrhea, you can use Smectite.
  • Astringent properties have decoction of rind of pomegranate, cherry, alder and cherry fruit.
  • Diarrhea in irritable bowel syndrome can help drug Alosetron.
  • You can use the products-sorbents, among which are: Polifepan, Enterosgel, Polisorb, Filtrum STI.

If IBS is accompanied by constipation

  • Will increase the volume of intestinal contents such drugs as: Naturolax, Mucofalk for 350 rubles, Ispaghol – price 250 rubles, Metamucil, Fiberlux for 150 rubles, Solgar Psyllium for 1200 rubles. All these preparations are made on the basis of a flea psyllium. With the addition of a synthetic pulp, kelp and agar can be purchased such as: Polycarbophil, Fibercon, Citrucel and Fiberall. The effect of their acceptance will continue for 10 hours after the first dose.
  • A popular tool for getting rid of constipation is lactulose that are related to the polyatomic alcohols. This drugs such as: Normase, Portalac, Duphalac, Rompala goodluck. You can assign them to people of any age, as they are not absorbed in the blood and help clear the intestines with constipation.
  • Similar lactulose effects have formulations based on polyethylene glycol. Their effect begins after 3-6 hours after the first dose. It is drugs such as Macrogol, Forlax and Lavacol cost of 200 rubles, Fortrans for 500 rubles, Relaxin, Osmogel, Transreg and lacteal – Exportal.
  • You can receive serotonin modulators: Prucalopride and Tegaserod.
  • Vaseline and vegetable oil are also have a laxative effect. In addition, you can use Norgalax, Picosulfate sodium (Slabilen drops for 100 rubles, Slabtop, Galassi, Guttalaks drops for 300 rubles, Lexical for 350 rubles, But Picosulfate for 150 rubles.
  • In addition, the laxative effect have mineral water enriched with magnesium ions. For example, it Essentuki №17.

From pain and spasms in IBS

  • Drugs from the group of the antifoams:Espumizan, Zealot, Policeman, Dimethicone. They contribute to the destruction of the gas bubbles, which often lead to painful sensations.
  • To adjust the motor and to reduce the pain capable Debridat as well as blockers of calcium channel, as Dicetel and Spasmomen.
  • In addition to the standard tools to remove the spasm – shpy and Drotaverina, can SRK be appointed antiholinergicakie drugs, as Darifenacin, Hyoscyamine, and Zamifenacin.

Antidepressants for IBS

It is no secret that irritable bowel syndrome is often an expression of psychological problems. However, even when the psyche is all right, by itself, the syndrome can lead to neurological disorders. And this can happen even with the most well-adjusted person. In this regard, doctors would prescribe such patients receiving tricyclic antidepressants.

Drugs in this group contribute to the reduction in the rate of the process of transmission of impulses by neurons from the spinal cord and brain to the intestine, and also reduce sensitivity to pain. In the end, violation of the chair and pain are eliminated, because of uneven contraction of the intestines either completely lost or significantly reduced.

  • The gold standard for the treatment of IBS with antidepressants is considered to be receiving Doxepin, Amitriptyline, Although, Imipramine and Trimipramine.
  • Modern practical medicine indicates that in psychosomatic disorders the most effective are the following drugs: Pirazidol, Eprobemide, Phenelzine, Moclobemide.

If IBS is accompanied by dysbiosis

If the background of irritable bowel syndrome in a patient diagnosed with goiter, it greatly complicates the course of disease, increasing discomfort. The pain becomes more intense, increasing bloating and irregularity. So dysbiosis is a need to eliminate mandatory.

To suppress the activity of pathogenic bacteria used:

  • Seven-day course of nitrofurans: Enterofuril, Furazolidone, Stop Diar.
  • In uncomplicated course of the dysbiosis can be replaced nitrofurans on probiotics with antibacterial activity. It can be: Baktisubtil, Enteral or tailored bacteriophages.
  • Perhaps the appointment of a fluoroquinolonefor example, Cefoxitin or Ciprofloxacin or Metronidazole, Trichopolum. Is also used intestinal antiseptic, Intetrix or antimicrobial agent is Rifaximin (Alfa normix).

Therapy should be supplemented with chelators, such as Enterosgel, Filtrum, Lactofiltrum.

When a course aimed at the suppression of pathogenic microorganisms to be completed, it is necessary to use drugs to normalize their own microflora. The greatest efficiency find show: Primadophilus, lineks, Bifidumbakterin, Normoflorin, Bifikol. They need to be taken throughout the month.

In addition, doctors prescribe drugs that create favorable conditions for the growth and activity of beneficial microorganisms in the intestines. It can be hilak-Forte and Lactulose.

Alternative therapies

As the pathology is due to transient functional disorders, the use of folk methods of treatment is quite justified. Additionally, there are traditional medicines that have been used for the correction of irregularities in the bowel, long before the advent of the term IBS. However, as in traditional medicine, to use the people's money should prudently and to comply with the measure.

  1. Medicinal plants. There are several plants that can help with irritable bowel syndrome:

    • Helps to eliminate spasms peppermint oil when used in oil burner.
    • Oak bark, a decoction of chamomile has long been known for its astringent properties. Fennel seeds, dill water, cumin seeds, Valerian root, spearmint, chamomile and anise drops will relieve the pain.
    • Sanguisorba officinalis, root of tormentil, plantain, coil, sage leaves, blueberries, walnuts – all these gifts of nature contribute to the elimination of diarrhea.
  2. Physiotherapy. Exercise can normalize the bowels. Better if classes will be held outdoors. It has a positive effect on the Central nervous system, and therefore helps to eliminate symptoms of IBS. Effects can be yoga, Pilates, brisk walking and Cycling. In Sweden Hattenbergstr the University held a special experiments, which allowed to establish that even 30 minutes of moderate physical activity a day helped reduce IBS symptoms in 50% of patients. You need to deal with up to 5 times a week.

  3. Mediation practice. Calm the nervous system using lessonsyoga. Sometimes they can be a great alternative to taking antidepressants. However, it is important that the patient himself could be configured to achieve the result. Better if the classes are held in groups. To summarize, we can conclude that for the treatment of irritable bowel syndrome is not as important drugs as a commitment to a regular way of life and belief in full recovery, which is quite real.