18 March 2019 Irritable bowel syndrome is a syndrome, that is, a set of symptoms , such as pain and abdominal distension, which tend to occur together. It is not a “disease” in the normal sense of the word (that is, it is not caught or transmitted from person to person, nor can it be cured by surgery or medicines) and it is not potentially fatal . Irritable bowel syndrome does not cause cancer, haemorrhage or inflammatory bowel diseases such as ulcerative colitis. In the long term , it may be associated with diverticulosis - a benign clinical condition characterised by the presence of diverticula (small pouch-like dilatations) in the intestinal wall, although it is not the cause of this. Occasionally, this condition can result in diverticulitis - an inflammation of one or more of these pouches, which may require surgical intervention. A diet rich in liquids and fibres can help to prevent diverticulosis and other bowel problems. Who is likely to be affected by irritable bowel syndrome? Irritable bowel syndrome is a common problem , affecting up to 30% of the Western population at some point in their life. It is usually diagnosed in young adults and its incidence is higher in women . What are the main causes of irritable bowel syndrome? Irritable bowel syndrome is thought to be the result of increased sensitivity of the colon to some foods and/or stressful situations . In these circumstances, a reaction associated with changes to the normal mechanism of rhythmic and sequential contraction and relaxation of the muscles in the intestinal wall takes place, which interferes with the normal progression of content through that digestive segment. These functional changes can result in an increase or decrease in the frequency and rhythm of muscle contraction and relaxation cycles. This has different consequences for the frequency of defecation and the consistency of the faeces . What are the symptoms of irritable bowel syndrome? Symptoms of irritable bowel syndrome include : Abdominal pain and distension; Malaise; Flatulence; Changes in digestive transit; Changes in faeces consistency. Some people have constipation , others have diarrhoea , while others may have a combination of the two . Faeces may also be covered with mucus . Irritable bowel syndrome never causes abnormal bleeding. Therefore, any anorectal blood loss should be carefully assessed by the relevant specialist. How is irritable bowel syndrome diagnosed? Diagnosis of irritable bowel syndrome is made on the basis of: Clinical history; Symptoms; Examination of the patient. Additional diagnostic tests to ensure symptoms are not the result of other problems may be necessary, including: Endoscopic examinations (sigmoidoscopy and colonoscopy); Laboratory tests (faecal occult blood, radiological tests and psychological assessment). These tests will rule out other diseases such as: Cancer; Diverticulitis; Intestinal inflammation; Depression. Is there any treatment for irritable bowel syndrome? Treatment of irritable bowel syndrome can include medical treatment together with dietary changes and stress management . Dietary changes For most people, an increased intake of non-digestible food is sufficient to alleviate symptoms . Fibre is not digested or absorbed and therefore remains in the intestine, where it not only attracts liquid into the area but also gives form and volume to the stools . These stools, which are softer and have more shape, stimulate intestinal movements , which make it easier for them to progress. In cases where the main complaint is diarrhoea , fibrous food should be ingested together with smaller amounts of liquid . As the faeces pass through the colon, much of the water present will be absorbed, which helps prevent diarrhoea . Where the principal complaint is constipation , the fibre should be ingested together with a lot of liquid , as this will help soften the faeces. In some cases, caffeine and other stimulants, alcohol and dairy products can aggravate symptoms associated with irritable bowel syndrome and may lead to diarrhoea or constipation. It may therefore also be necessary to avoid the consumption of : Coffee; Tea; Chocolate; Alcoholic beverages; Milk; Cheese; Butter and other dairy products. Milk and dairy products , which are an important source of various nutrients, should only be excluded from the diet on the express recommendation of the doctor . Sometimes dietary changes on their own are not sufficient to provide adequate relief from abdominal cramps and flatulence. Medicinal products and psychological help In cases where dietary changes do not relieve symptoms, medicinal products that act directly on the intestinal muscle may be prescribed to help the patient return to normal functioning. For some people, help from a psychologist may also be needed to identify and control factors that cause them stress (relaxation training) in order to help relieve symptoms. Nicotine can also contribute to the aggravation of symptoms associated with irritable bowel syndrome, so smokers should be made aware of this fact. Improvement or resolution of the symptoms of irritable bowel syndrome is often a slow process, which can take 6 months or longer . A great deal of patience is therefore required for the treatment of this problem. Mild symptoms may recur from time to time. In some cases, although this is rare, symptoms may even reappear with greater intensity. Gastroenterologists and general surgeons can help to treat this disease. This article was written with the support of physicians and other clinical professionals from the Hospital da Luz network . The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
