Irritable Bowel Syndrome:
I see many patients with this condition. The most common problem I see is that these patients have not explained what is IBS. Most of them have symptoms for many years, seen many doctors, even gastroenterologists, but had no satisfactory explanation for their symptoms. Nobody takes the time to sit down and explain these things. That is too time-consuming and often futile as most patients are looking for a quick fix or magic pill that does not exist.
In these days of Google, one can enter only a few symptoms and come to a diagnosis that can be soothing or absolutely jarring on my nerves with all the missed diagnosis, misdiagnosis place. So, before you know, you're thinking that a strange and deadly disease has struck, and the end is near!
That is why I am writing about IBS.
So here goes ......
When you eat food and drink water, chewed material travels down the throat, food pipe and stomach where it mixes with acid and churned in the porridge-like substance. It then passes through 25 m of the small intestine where all the important nutrients and absorb this mixture to the mash, and now acid gas formed by bacteria breaking down undigested food has to navigate through this narrow crashed plumbing inside your body. Imagine your food passes through one of those clown balloons long before it was inflated. It moves by peristalsis, which is smooth, rhythmic contractions that propel food this mixture of air and water, ahead.
This is what happens under stress free situations as if you lived in a utopia! I do not know a man who lived there. We live here in New York or the likes of big and small cities with the stresses of everyday life. People tell me all the time that they are happy and no stress! Do you believe that? I have yet to meet a person who has stress in their lives. To stress a family man could be that you lost your job and no money to pay bills or teen to have a pimple on their face on prom nite, stress is the same, but we simply can not equate these terms to be equal. We are always 'stress du-jour' and all of them take advantage of one by one. This can only be an act of getting up in the morning to get ready for work, school or run their house hold. Catch a bus or train ride on those highways, getting late for work, deadlines, now throw in some exams for students, shouting at his boss, due to friction with his co-workers, friends, boy friends, husbands, wives, finances, job insecurity , accounts, etc, etc. I think you get the point, life stress.
So, under such situations, the brain secretes certain hormones, chemicals and neurotransmitters that act on the intestines which causes him to go into spasms. intestines are like a long sausage links, or small pouches or bags. With these cramps sausages or bags get stretched with trapped air, and thus you feel full. Water is absorbed and the stool becomes hard and also trapped in these sacs, and not to move forward. You feel uncomfortable with belching, burping, feeling full, you can move your heart. At the end of the spasm relaxes uncertain, some segments become hyperactive and / or stay contracted. When a bowel movement, it's a little hard pebble like stools, soft mushy stools or diarrhea, or a combination of all in the same chair, sometimes associated with the mucosa. There is a feeling of incomplete evacuation, and continue running to the bathroom and again as you need to feel better, so you can get out of the house and go about your day. For people who get diarrhea often a big effect on the brain to cause a hyperactive little contractions that make the small bowel and is one of frequent soft or watery stools.
Some people have rectal pain and discomfort due to pressure in the pelvic area with a distended intestine and rectum.
Another important fact is that people with IBS are hypersensitive to the amount of air in the intestines. This is called visceral hyper-sensitivity. For example, if we insuffulate 100 cc of air in the normal colon, there is no pain or discomfort, but the same amount of air for the same amount of distortion in the IBS patient will cause pain and discomfort. neurons as they are inflamed and raw materials in these cases, the bacteria are to blame for that, and thus the role of probiotics and intestinal flora changes with better bacteria. Since billions of bacteria in the intestine, most do not seem to have any role, a small amount of them are useful, many of them are a nuisance and only a very minute amount are harmful. The purpose is to instill good probiotic bacteria which can then multiply and get rid of those nasty. Getting the right type and amount of bacteria is a trick, and we just learning about them. These billions of bacteria have a complex role as they live in us and our work with all cellular and biological functions. Over the next several years, as we put together the DNA structure of the microbiome, we will be able to understand IBS, diabetes, obesity, and I believe that even a heart attack and cancer, the better.
Some people will have a classic text book symptoms of IBS, and some will have only a few of these symptoms. Rome II Criteria IBS is:
The symptoms of recurrent abdominal pain or discomfort, and marked a change in bowel habits for at least six months, with symptoms experienced at least three days at least three months. Two or more of the following must apply:
Pain relieved by bowel movement
Starts pain is related to changes in frequency of stool
Starts pain related to a change in the appearance of the chair.
Management of IBS:
Remember that IBS is a long term condition that can flare up again and again and change over time.
It does not shorten life expectancy or predisposition to cancer or other diseases.
Certain foods can trigger, and keeping a diary, or keep track of what foods trigger some of these symptoms may be worth.
life-style habits do not cause IBS, but reduces excess and stress, sleeping well, exercising regularly and eating healthy will help.
Eat 5-6 small meals more frequently throughout the day instead of 3 regular meals.
Do not eat on the run and avoid fatty, large meals.
Avoid the offending food for about 3 months, reduce coffee, nuts, chocolate, insoluble fiber such as cereal fiber, alcohol, sorbitol-containing candy and gum, beans, bagels, raisins, onions, lentils, broccoli, cauliflower , cabbage, broccoli, peas, soybeans, etc. The list is long and you can not avoid all foods, so you have to be your own detective. Food allergy blood tests are not very helpful because you are not allergic to food, just intolerant or sensitive to them.
Soluble fiber is better than insoluble less available to bacteria act on them and thus cause less gas. Soluble fiber in fruits and vegetables and insoluble fibers found in whole grains and cereals.
to ask for help from a knowledgeable physician, so that appropriate tests and work to be done to exclude any medical conditions.
No comments:
Post a Comment