Irritable Bowel Syndrome (IBS)

A professor in Gregory University Uturu, after about 30 years sojourn in USA, joined the school about two to three years ago.

He consulted me for the first time two years ago. After describing his symptoms, which were centred around his abdomen and bowel movement, I just told him, “Prof, it is likely you have Irritable Bowel Syndrome.”

The professor jumped off his seat and shouted, “It took the American doctors almost three good years to diagnose my illness after subjecting me to countless tests and medical torture. They finally told me after three years that I have irritable bowel syndrome, “but look at an African doctor after five minutes, he hit the nail on the head and properly diagnosed what I am suffering from, and they say Africans are not great.”

   Let me begin from the beginning. Irritable Bowel Syndrome (IBS) is a disorder of the large bowel (colon) in which the bowel overreacts to a mild stimulus, such as eating or the presence of gas by going into spasm. It is also known as “spastic colon”.

Irritable bowel syndrome is present in 10 to 20 percent of adults in Nigeria. One study conducted by (late) Prof. A Ikeme in University of Jos, in the 80s, showed the prevalence of IBS symptoms in respondents to be 19.5 percent.

   The prevalence is similar in Europe, although it may be lower in Asia and higher in other parts of Africa. VIn the UK and US a cross sectional postal survey conducted in a sample of their adults (4,476 people aged 20 – 69 years), reported a prevalence of IBS equivalent to 16.7 percent with a higher rate among women (22 percent) compared to men – 10.5 percent

   In Australia, a postal questionnaire of 4,500 people aged 18 years showed prevalence for IBS, according to Prof Manning, to be 13.6 percent. 

   Equivalent types of postal surveys conducted in Asia found similar prevalence in China 11.5 percent. 

   Among those who seek medical help for IBS females outnumber males at a ratio of 2:1. There are three types of Irritable bowel Syndrome or IBS which include:

IBS with constipation – This comes with stomach pain and discomfort , bloating abnormality, delayed or infrequent bowel movements, or loose/watery stool.

IBS with diarrhoea – This comes with stomach pain and discomfort, and urgent need to more your bowel, abnormally frequent bowel movements or loose watery stool.

IBS with alternating constipation and diarrhoea – there are about an equal number of people with IBS in each category. There is also evidence that most people with IBS will alternate between the two types over time. 

   The risk factors for IBS may include may include abnormal movements of the colon and small intestine

   Hypersensitivity to pain, caused buy gas or full bowels. A viral or bacterial infection of the stomach and intestines, that is gastro- enteritis.  Small intestinal bacterial overgrowth. Reproductive hormones or neurotransmitters may be off – balance in people with IBS.

   Anxiety and depression may accompany IBS, though these have not been found to be-direct causes of IBS. The exact cause of Irritable Bowel Syndrome (IBS) is unknown. Potential causes may include sensitivity to gastro-intestinal tract to gas and bloating, alteration of faecal flora (bacteria), within the intestines, or altered levels of specific compounds or chemicals. Within the body, such of serotonin.

   Having a recent GI track infection and having a history of IBS,  may also be a risk factor for IBS. Although stress does not cause IBS, many people with IBS indicate that stress does aggravate their symptoms.

   Hormones may also play a role in IBS,  for example many women often report more symptoms when they are menstruating. 

   In addition, many people with IBS report  more symptoms after eating specific foods and beverages, such as spicy foods, certain fruits and vegetables, foods containing wheat, coffee, and alcohol drink. 

   The main symptoms of IBS are abdominal pain or discomfort that is often relieved by passing wind or faeces. Stomach bloating. Chronic diarrhoea or constipation or alternating between the two.

   Other symptoms of IBS are whitish mucus in the stool, the feeling that you have not finished a bowel movement and nausea. IBS can be painful; however, it does not damage the colon or other parts of the digestive system. IBS does not lead to other health problems. 

   During a physical examination your doctor usually checks for abdominal bloating, listens to sounds within your abdomen using a stethoscope. Taps on your abdomen checking for tenderness or pain. 

   Doctors use blood tests to check for conditions or problem other than IBS . A stool test is the analysis of a sample of stool. Your doctor will give you a container for catching and holding a stool sample. To check for blood or parasites.

   Flexible sigmoidoscopy is a procedure that uses a flexible narrow tube with a light and tiny camera called sigmoidoscope, on one end to look inside your rectum and lower colon.

   This procedure can show signs of conditions or problems in the lower GI tract. During the procedure the doctor can take a biopsy. You won’t feel the biopsy.

   Colonoscopy is a procedure that uses a long flexible, narrow tube with a light and tiny camera called colonoscope on one end to look inside your rectum and colon. Colonoscopy can show irritated or swollen tissues, ulcers, polyps and cancer. A trained Specialist performs this procedure.

   A lower GI series, also called Barium Enema, uses X-ray to look at your large intestine. During lower GI series, you will be asked to lie on a table while the doctor inserts a flexible tube into your anus. The doctor will fill your large intestine with barium. You may be asked to change positions several times during the test.

   Discussions between you and your doctor can help decide the appropriate treatment plan for your specific needs. Different treatment work for different types of Irritable Bowel Syndrome.

   Avoiding individual triggers can help many people with IBS. Others choose to take medications at times when their IBS is playing up.

   Anti-diarrhoea agents, example Imodium, lomotil, fibre supplements can be an essential part of management in those with diarrhoea predominate IBS.

   Pain relieving medications example opiates such as codeine, can provide effective pain relief. One of their most common side effects constipation, may also relieve the diarrhoea of diarrhoea IBS. Pain relief may also be obtained from medications that reduce bowel spasms .

   Constipation treatment, example fibre supplements or laxatives may provide relief for constipations predominant IBS.

     Antispasmodic agents example mebeverine, belladonna, hyoscine and peppermint- oil capsules  may ease cramping.

   Tricyclic anti-depressants can be effective in treating the pain of IBS, but are best prescribed for a trial period with monitoring of symptoms. Use of these medications does not mean that IBS is caused by depressions.

   Establishing eating routine and avoiding sudden changes of routine will help in treating Irritable Bowel Syndrome. 

 Always be medically guided.

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