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Re: Looking for info on IBS !!!!

Posted By HFHSM.D.-ym on July 07, 1998 at 14:08:29:

In Reply to: Looking for info on IBS !!!! posted by Cheryl on July 06, 1998 at 18:31:44:

I had a doctor's appointment today and the doctor said I have IBS.
At first my primary said it was diverticulitis. But now the specialist says
it is IBS. I also suffer from migraine headaches. I would appreciate any
and all info anyone can provide re this disease, such as diet changes etc.
The doctor has prescribed Librax and to learn to de-stress as much as
possible. That is tough when you own your own business and have a kid
going off to college and a 10 year old at home with learning problems.
Any suggestions out there ? I want to learn as much as I can to get out
from under this thing. At least I don't have to go for the colonoscopy
they said I might need. That is a relief in itself.
Thanks in advance for any help you may be able to offer.
Dear Cheryl,
Irritable bowel syndrome is a gastrointestinal syndrome characterized by chronic (present for at least 3 months) abdominal pain and altered bowel habits in the absence of any organic disorder. Approximately 10-20% of the general adult population report symptoms compatible with irritable bowel syndrome. The abdominal pain is usually described as a crampy sensation with variable intensity and periodic exacerbations and is generally located in the lower abdomen. Bowel habits in patients with irritable bowel syndrome can be diarrhea, constipation, diarrhea alternating with constipation or normal bowel movements alternating with either constipation or diarrhea. Approximately half of all irritable bowel syndrome patients will complain of mucus discharge with stools.
The definitive cause of irritable bowel syndrome has not been established. Many studies have reported changes in gastrointestinal motility in patients with irritable bowel syndrome, however, these studies have not been consistently reproduced nor has a particular pattern been detected. Up to 60% of patients with irritable bowel syndrome have a lower tolerance for rectal balloon distention than normal controls. This exaggerated response to colonic distention is termed visceral hyperalgesia and is probably mediated by an as yet undetermined defect in the nerves that control pain sensation. It is not clear whether this is a problem with the nerves of the gastrointestinal tract or the brain. Although irritable bowel syndrome is not caused by a psychiatric problem; psychological disorders, stress, emotional difficulties and  a history of childhood sexual or physical abuse are more common in this patient population.
There are however, a number of symptoms that do not suggest the diagnosis of irritable bowel syndrome. These include: large, volume stools with weight loss, fever, blood in the stool and abdominal pain which awakens one from sleep. If a patient has any of these symptoms a work-up should be initiated to exclude an organic disease process.
If the patient has the typical symptoms of irritable bowel syndrome an exhaustive work-up is unnecessay. Many gastroenterologists will perform a complete blood count, sedimentation rate and a chemistry panel. If diarrhea is the predominant symptom, stool examination for culture, ova & parasites and white blood cells as well as thyroid function tests should be performed. In patients over 40, a flexible sigmoidoscopy (a test where a tube with a light and video camera is introduced into the rectum and advanced to about 60 cm-this will allow direct visualization of the left side of the large intestine and rectum; sometimes a biopsy is performed to exclude a series of intestinal disorders which can cause diarrhea) is usually performed. In patients with a family history of colon cancer, a colonoscopy is perfomed.
A number of treatments have been suggested to help patients with irritable bowel syndrome. The first step is to have a good working relationship with your physician. You should review your diet carefully to see if they are playing a role in your symptoms. Many patients have symptoms with dairy products and other gas producing foods. Exclusion of foods that can increase flatulence (beans, onions, celery, carrots, raisins, bananas, apricots, prunes, brussel sprouts, wheat germ, pretzels and bagels) may be helpful. Some patients find that decreasing the intake of caffeinated beverages may help as well. This does not mean that you have to refrain from all of these foods. What you should do is try these foods and see if they cause a problem. If they do then you should avoid them. Furthermore, many patients find that increasing the fiber in their diet to obtain 20-30 grams daily helps regulate their bowel movements. An easy way to do this is to take a high fiber cereal such as FIBER ONE or ALL BRAN on a daily basis. There are medications to decrease spasm or to relieve diarrhea, but they should be tried only after the above is accomplished. You should give the fiber at least a month to work. You may get some increased gas and bloating initially but most patients can eventually tolerate the fiber. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you want to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
*Keywords: irritable bowel syndrome, causes, treatment


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