If you have complaints such as abdominal pain, bloating, diarrhea, or constipation once a week for at least 3 months, beware! Yeditepe University Kozyatağı Hospital Gastroenterology Specialist stated that these symptoms point to irritable bowel syndrome and answered questions about what irritable bowel disease and its symptoms are and the treatment of irritable bowel disease.

What is Irritable Bowel Syndrome?

Irritable bowel syndrome, also known as irritable bowel disease among people, is a very common problem in the community. However, patients may lose time until they are treated because it is not well known or is confused with different diseases. Moreover, due to the difficulties experienced during this period, it may also cause a loss of workforce. Therefore, the problems and stress caused by IBS can also cause a decrease in the quality of life.

Although its frequency varies from community to community, the incidence is approximately 15%. About 50% of all adults with chronic abdominal pain and irregular defecation have functional bowel disease.

What are the Symptoms of Irritable Bowel Syndrome?

Although the symptoms of irritable bowel syndrome differ from person to person, there are some distinctive signs of the disease. It manifests itself with changes in defecation habits such as diarrhea and constipation along with abdominal pain. In IBS, along with abdominal pain, constipation in the predominant form of constipation, diarrhea in the predominant form of diarrhea, or a mixed form of constipation-diarrhea attacks together can be seen. Typically, symptoms include flatulence and bloating.

However, since IBS, organic and functional bowel diseases are often composed of intertwined symptoms, it is of great importance to rule out organic diseases first.

In organic diseases, the patient's history, examination, laboratory, and tests guide us.

• In the history; Weight loss, sudden onset in advanced age, awakening symptoms at night (abdominal pain and defecation, which are especially common and awaken at night), bloody diarrhea, rectal bleeding, family history of cancer, and inflammatory bowel diseases.
• In the examination; Fever, abdominal mass, skin and joint findings, and malabsorption findings help us in differentiation.
• In the laboratory findings; Anemia, fecal occult blood, and abnormal biochemistry findings are warning signs to rule out organic diseases.
   

Duration of Irritable Bowel Syndrome Complaints

Symptoms must have started at least 6 months ago. Abdominal pain recurring at least once a week for the last 3 months and changes in defecation frequency, and defecation form, that is, its appearance suggest IBS.

What Causes Irritable Bowel Syndrome?

Although the exact cause of IBS is unknown, some factors are known to increase the risk of developing the disease. Previous intestinal infections, hypersensitivity of the brain-intestinal anus, increased levels of certain inflammatory cytokines, and increased intestinal permeability increase the risk. Abnormal contractions of the muscles in the intestinal wall, nervous system abnormalities, changes in brain-intestinal signal transmission, and disturbances in the balance of bacteria living in the intestines are among the factors that cause IBS.

Who Suffers from Irritable Bowel Syndrome More Often?

Irritable bowel syndrome, which is more common in women and young people, may be accompanied by extra-intestinal symptoms such as depression, anxiety, fibromyalgia, headache, and chronic fatigue. The exact reason the disease is more common in women has not been revealed yet.

Is Irritable Bowel Syndrome Dangerous?

Most of the patients present to the physician with concerns about cancer. For this reason, it is very important to make a definitive diagnosis with differential methods first. However, people diagnosed with IBS should know that this situation does not have a risk of turning into a serious disease in the future and does not lead to cancer.

How to Treat Irritable Bowel Syndrome?

In the treatment of IBS, first of all, the patient must be informed very well about what the condition is. Since it is a chronic disease, it needs to be managed in the long term. Otherwise, the patient will have to experience this problem again and again.

Treatment is continued for the predominant symptom. Among the different treatment methods, including diet, medication treatment, and psychotherapy, those that are suitable for the patient are used.

However, in addition to medical treatment, the patient has to go through some changes in his/her daily life. For example, exercise. Walking for 45 minutes daily will make a difference in the reduction of complaints in a very short time. In addition, nutrition is extremely important. Fast food should be avoided, a healthy, adequate, and balanced diet should be preferred, meals should not be eaten fast, attention should be paid not to eat late at night, and smoking and alcohol should be avoided.

What Kind of Changes Should There Be in the Diet Applied in the Treatment of Irritable Bowel Syndrome? Which Foods Should Be Restricted?

In IBS, frequent but small meals should be preferred, eaten slowly, and chewed well. Fatty and spicy foods, carbonated drinks and sweeteners, and alcohol and caffeine consumption should be reduced. The ones that are cooked by boiling rather than frying should be preferred, a sufficient amount of liquid, preferably water, should be taken. Tea consumption and intake of milk and dairy products should be restricted, and fiber intake should be spread evenly throughout the day.

What we call Low FODMAP Diet is;

Removal of Fermentable Oligo-, Di-, Monosaccharides, and Polyols that can be fermented by intestinal bacteria from the diet.

• Foods containing oligosaccharides; Wheat, barley, rye, onion, leek, garlic, artichoke, beet, fennel, green pea, chicory, peanut, cashew, lentil, chickpea
• Foods containing disaccharides; Milk, ice cream, yogurt, cream
• Foods containing monosaccharides; Apple, mango, honey, high fructose corn syrup, pear, watermelon, asparagus
• Foods containing polyols; Apple, pear, nectarine, watermelon, mushroom, flavored gums, apricot, peach, cauliflower, plum

However, this diet has problems such as malnutrition, cost, and maintenance of the diet. Hearsay information also increases these problems. Therefore, in order to minimize the problems, conducting the diet under the control of competent specialists minimizes the problems.

How Do Stress and Anxiety Affect Patients with Irritable Bowel Syndrome?

Stress, anxiety, and depression are some of the triggering factors that can lead to the emergence of IBS.
Although the etiology of functional bowel diseases is not fully understood, it is thought that a complex interaction between genetic and environmental factors, causing an excessive and inappropriate inflammatory response, triggers the picture.

Although functional bowel diseases are not psychological, it is known that psychological problems increase symptoms.
Psychological diseases are often associated with impaired cellular immunity and increased inflammation.

The impaired immune response also plays an important role in the pathogenesis of functional bowel diseases.

There is also a relationship between the gastrointestinal tract and the brain, in which there is a bidirectional signaling system, often involving the gut microbiota. As a result, disruptions in the gut-brain axis can lead to the emergence of the disease. In light of these data, it is important to evaluate and treat underlying psychiatric diseases in the treatment of functional bowel diseases.

In addition, we recommend the patient focus on activities that can control stress and help him/her stay away from stress.