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Integrated Pain Management


Irritable bowel syndrome (IBS) 

Irritable bowel syndrome is a common disorder affecting the colon or large intestine. This disorder is characterized y abdominal pain, gas, constipation, cramping and diarrhea.

This disorder is chronic and requires long-term management. Irritable bowel syndrome is a functional gastrointestinal disorder and has no known cause.

Irritable bowel syndrome

Though irritable bowel syndrome will have uncomfortable symptoms, the disorder will not cause any changes to the bowel tissue and will not put the patient at a risk of colorectal cancer.

This disorder may occur after a stressful event in life or after an infection and will vary with age. The most common theory used in explaining irritable bowel syndrome is that there is an interaction disorder between the gastrointestinal tract and the brain.

 In some cases there are abnormalities in the gut flora and these abnormalities are theorized to be the cause of inflammation and the altered bowel function.

There are only a few people with irritable bowel syndrome that have reported severe symptoms. Some people have managed to control the symptoms through managing their stress, following a specific diet and making lifestyle changes accordingly.


The signs and symptoms of irritable bowel syndrome will differ with individuals and in most cases will mimic symptoms of other conditions and diseases.

The most common symptoms described by irritable bowel syndrome patients include abdominal pain or cramping, gas, bloating, mucus in the stool, constipation and diarrhea (sometimes the diarrhea and the constipation will alternate).

For most patients, irritable bowel syndrome is a chronic condition meaning that it is long lasting but there are times when the symptoms will be worse, and in other times, the symptoms will disappear completely.

There are a lot of people with irritable bowel syndrome but only a few seek medical attention. Individuals who experience a persistent alteration of bowel habits should seek medical attention especially if there are other symptoms of irritable bowel syndrome as this might be a serious condition such as colon cancer.

Symptoms such as rectal bleeding, weight loss and abdominal pain that worsens at night are signs of a serious condition.


The cause of irritable bowel syndrome is not clearly understood but there are a number of factors that are known to contribute to the development of the condition.

The muscles of the large intestines have muscle layers which contract and relax to move the food to the rectum. In people who have irritable bowel syndrome, the contraction might last longer and may be stronger than normal and this is what causes the gas, the diarrhea and the bloating.

The muscle might also relax longer than needed leading to the slow movement of food and causing dry stool or constipation.

Gastrointestinal nervous system abnormalities have also been found to play a role in causing discomfort when the abdomen stretches for stool and gas.

Poor signaling between the intestines and the brain can lead to overreaction of the changes that occur in the digestive process in a normal manner. The overreaction is what leads to constipation, diarrhea and abdominal pain.

There are factors that are known to trigger irritable bowel syndrome and will vary from one person to the other. The most common triggers of irritable bowel syndrome include:


The role of intolerance and allergic reactions to food in relation to irritable bowel syndrome is not yet understood clearly.

What is apparent is that some food will worsen the symptoms. Some of the foods that have been implicated include spices, chocolate, beans, cabbage, cauliflower, milk, broccoli, milk, alcohol, carbonated drinks, fats, fruits among many others.



Women are more likely to develop irritable bowel syndrome than men and this is what leads to the suggestion that hormonal changes might have a role in irritable bowel syndrome.

Most female patients have discovered that the symptoms worsen around or during their menstrual periods.


Most patients suffering from irritable bowel syndrome have described an increase in the intensity of the symptoms especially when they are stressed such as when in a new job or during examinations. Stress is not known to cause the symptoms, it simply aggravates them.

Other Illnesses

There are cases where other illness such as gastroenteritis referred to as acute diarrhea, or the bacterial overgrowth in the intestines are known to be triggers of irritable bowel syndrome.

Risk Factors

A lot of people will have occasional symptoms of irritable bowel syndrome but the risk is increased if the person is:

  1. Young – Irritable bowel syndrome has been found to affect people who are under the age of 45 years.
  2. A female – Twice as many women are affected by irritable bowel syndrome and this being female is listed as a risk factor.

From a family with an irritable bowel syndrome history – Studies have indicated that people from families with irritable bowel syndrome history are at a greater risk of developing the condition.

This influence may be related to shared factors in a family’s environment, genes or both.

Suffering from a mental health problem – Depression, anxiety, personality disorder and a history of child abuse are risk factors for some women, domestic abuse is a risk factor.


Irritable bowel syndrome diagnosis depends on the medical history of the patient and physical examination. Because of a lack of physical signs that will assist in the diagnosis of irritable bowel syndrome, the process involves elimination of other conditions that might be causing the symptoms.

Rome criteria is used and diagnosis is made if eth patient has certain signs and symptoms. The Manning criteria focuses on pain relieved by defecation mucus in the stool, inconsistent stool and incomplete bowel movements.

Additional test might include colonoscopy, flexible sigmoidoscopy, x-ray, CT scan, low GI series, lactose intolerance tests, stool test, blood test, and breath test.


Because the cause of irritable bowel syndrome is not known, the treatment focuses on the alleviation of the symptoms to allow the patient to live a normal life.

Mild cases of irritable bowel syndrome can be controlled in most cases through the leaning of stress management a change in diet according to food triggers, exercise, fluids and enough sleep.

If your condition is moderate or severe there will be a need of more than just a change of lifestyle.

For moderate to severe cases of irritable bowel syndrome doctors will recommend the elimination of high gas foods, elimination of FODMAPs, and the elimination of gluten.

Medications recommended will include fiber supplements, anticholinergic and antispasmodic medication, anti-diarrhea medications, antibiotics, antidepressants and counseling to deal with the stress and depression.