Irritable bowel syndrome is obviously a constellation of symptoms involving altered bowel habits as well as abdominal pain. This is a very common disorder and it is without a doubt a very real disorder. This is not something that is imagined or perceived. The exact nature of it, the ideology of it is not clear but in part its probably due to visceral hyper sensitivity but there’s definitely issues with the neuromuscular function of the digestive tract and probably the brain gut access. It’s usually manifested in the form of either abdominal pain, diarrhea, constipation or some combinations of the above.
There are specific triggers, stress seems to be a trigger in a lot of folks, certain folks have difficulty that they denote certain foods or certain social situations give them trouble. There is no one size fits all trigger but again it varies from person to person. IBS is treated based on the predominant symptoms and so certainly anyone who has IBS or thinks they have IBS warrants a thorough evaluation. There is no standard evaluation because the IBS evaluation is different for a healthy 18-year old male or female than it would be for a 50-year old who thinks they may have IBS. So it’s the evaluation certainly depends based on the patient and the treatment depends basically on the symptoms. If people are having problems with diarrhea, those can be treated with certain types of medications, perhaps with dietary changes. Constipation is frequently treated with fiber or other bulking agents as well as the use of laxatives but the key point to this is tailoring therapy to the individual person. I think that’s ultimately the goal as to improve quality alive and to tailor that treatment to the individual patient.
IBS and food intolerance are not exactly the same thing. IBS is an established diagnosis that again is a constellation of symptoms. Food intolerance is a bit of a broader category that in some folks again who have IBS they may note that certain food, their intolerative of certain foods and that they trigger their IBS symptoms but I would not consider them the same thing. One thing I think is worth mentioning is now we’re learning more about something called iliac disease which is intolerance to wheat and its basically an allergic reaction to wheat. There are a number of folks in the past who have been diagnosed with irritable bowel syndrome who very well could have iliac disease. This is going back 10 or 15 years ago with something we thought only occurred in the pediatric population. But now we’re more aware that this can have a very complicated manifest itself in very different way and certainly the adult population is at risk as well. This are people who cant present with irritable bowel type syndromes, so certainly this iliac disease has to be considered in the differential of someone presenting irritable bowel type symptoms.
There is probably not a lot we can do to prevent it, I think for the vast majority of people, we are very good at treating. There is no cure but I think we are very good at controlling symptoms and trying to get folks diet to enjoy their life and doing the things they want to do and not allow their symptoms to dominate their daily lives.
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