Nervous stomach or irritable bowel syndrome. Irritable bowel syndrome: symptoms, treatment. With predominance of diarrhea

Gastroenterologists are in doubt: shouldn’t the treatment of patients with irritable bowel syndrome be delegated to psychotherapists? There is no doubt that they should act together. No one also doubts that this, one of the most common gastrointestinal problems, should be treated at home.

Irritable bowel syndrome (abbreviated IBS) is a functional disorder in which the patient experiences abdominal pain for at least 12 weeks for at least 12 weeks, noticeably decreasing or disappearing after defecation, accompanied by changes in stool frequency and stool structure.

IBS may include:

• pain in the flanks of the abdomen and hypochondrium, especially in the morning, subsiding after bowel movement,
• constipation (stool less than 3 times a week),
• diarrhea (stool more than 3 times a day), and
• sudden uncontrollable urge to empty the bowels,
• feeling of incomplete emptying, need to strain,
• flatulence, feeling of fullness in the stomach,
• mucus in stool.

With IBS there is no:

• blood in stool
• weight loss
• stomach pain at night,
• temperature rise,
• enlarged liver and spleen,
• anemia, increased levels of leukocytes and ESR,
• alarming symptoms are the onset of the disease after 50 years and rectal cancer in the patient’s relatives.

As with any functional disorder, a diagnosis of IBS can be made once all other problems have been ruled out.

The list is not small and unpleasant, however, undetected colon cancer, hypo- or hyperthyroidism, or lymphoma is much worse.

How to treat irritable bowel syndrome?

Learning how to respond to stress and relax is important in treating irritable bowel syndrome.

First of all, a consultation with a psychotherapist is necessary. The ability to cope with stress, anger and fear, to get out of conflict situations without loss is what a patient with irritable colon needs first of all. Hypnosis, relaxation therapy or antidepressants - let a specialist decide in each specific situation.

Daily regime

Lack of sleep and physical activity significantly worsens the course of the disease. At the same time, the formed habit of emptying the intestines in the morning after breakfast prevents habitual constipation. A glass of cold water immediately after waking up in combination with morning exercises, especially “scissors” and “bicycle” exercises, promotes regular bowel movements.

Diet

It is advisable to exclude all food additives, or at least carefully study their composition. Often, such powders and capsules contain laxatives, which lead to a change in the nature of the stool.

Xylitol and sorbitol, which are contained in some chewing gums, have a laxative effect. Therefore, if you are prone to diarrhea, it is also advisable to avoid them.
Carbonated drinks, alcohol and caffeine do not have the best effect on intestinal function; this is a common problem in patients with irritable bowel syndrome.

If you have constipation, you should pay attention to your drinking regime (at least one and a half liters of fluid per day), and a sufficient amount of unrefined foods rich in plant fiber in your diet. These are vegetables and fruits, if well tolerated - raw, for severe pain and flatulence - boiled. It is good if the diet includes bran or microcellulose preparations.

Drug treatment

• Antispasmodics will help with pain: duspatalin (0.2 g, 2 times 20 minutes before meals) or dicytel (0.05 g, 3 times a day with meals), spasmomen (40 mg, 2 times before meals or 20 mg suppositories. 2 times). No-shpu, papaverine, buscapan can also be used, but given the side effects and contraindications (hypotension, glaucoma, prostate adenoma) this is not the best choice.
• . Here you cannot do without antidiarrheal drugs: loperamide (imodium) 2-4 mg per day; astringents – smecta 1 sachet 3 times a day, calcium carbonate 0.5 grams 3 times a day; herbal remedies - decoctions of bird cherry and blueberry fruits, rhizomes of cinquefoil and serpentine, alder fruit; Mint and chamomile have an antispasmodic effect.
• . Taking prokinetics – Motilium, Coordinax 10 mg – helps normalize motor skills. 3 times a day. Among laxatives, it is better to choose lactulose (Duphalac) 30-50 ml in the morning, or psyllum (Mucofalc) 3-4 grams 2 times a day. In addition to the ability to increase the volume of feces and enhance peristalsis, they also have a prebiotic effect - i.e. normalize intestinal microflora. But herbal laxatives - hay, buckthorn, aloe, rhubarb - can increase pain and cramps.
• . Preparations based on simethicone (espumisan 40 mg 3 times) and dimethicone.

The prospects for irritable bowel syndrome are favorable: it does not cause severe complications and does not reduce life expectancy. By slightly changing your diet and physical activity, and most importantly, your attitude towards life to a more optimistic one, you can achieve noticeable positive changes in your well-being.

Which doctor should I contact?

If you have problems with the intestines described in the article, you need to contact a gastroenterologist. A psychologist or psychotherapist will provide additional assistance. The diagnosis of irritable bowel syndrome is a diagnosis of exclusion, therefore, before settling on it, the patient should be carefully examined to exclude other pathologies of the gastrointestinal tract.

Psychotherapist on the psychological aspects of irritable bowel syndrome:

Intestinal disorders that plague the daily life of the average person can be the result of infection, dietary errors, dysfunction of the gastrointestinal tract, etc. Few people suffering from the disease know that irritable bowel syndrome can be a common cause.

IBS- a common intestinal disease, characterized by the absence of organic causes, but accompanied by chronic pain, such symptoms as bloating and discomfort.

At risk are adults aged from 30 to 40 years. IBS affects 20% of the world's population, the syndrome is more common in women, 12% of sufferers are the weaker sex, and the same percentage of patients go without medical care.

In the absence of disorders in the nervous system of the intestine, a periodic failure occurs in the regulation of the functions of contraction and relaxation of the intestinal muscles. Thus, accelerated intestinal motility can be associated with diarrhea, and slow activity is manifested by the occurrence of constipation, and with sudden muscle contractions a feeling of pain and discomfort occurs. Motor dysfunction is a common cause of IBS symptoms.

Dysbacteriosis

A minimal change in the qualitative and quantitative position of the intestinal microflora can cause intestinal irritation. With the syndrome developed against the background, the patient suffers from excessive gas formation, sudden weight loss, and diarrhea.

Hereditary predisposition

Irritable bowel disease is a cause for concern for people who have relatives affected by IBS.

Hormonal background

Irritation of the intestines can occur due to changes in hormonal levels, a common occurrence in women. The menstrual cycle, pregnancy, lactation are conditions that affect the surge of hormones and leave their mark on the functioning of the gastrointestinal tract.

Menstruation or menopause is a surge of hormones that affects the functioning of the gastrointestinal tract.

Nutrition

Low-quality, high-calorie, processed food is a provocateur that influences the development of IBS symptoms. Alcohol, energy drinks, carbonated drinks, caffeine, chocolate - this is not a complete list of products that irritate the intestines.

Signs of Irritable Bowel Syndrome

The symptoms of IBS are similar to those of an elementary intestinal disorder; they occur in attacks and can intensify after eating. Symptoms in a significant proportion of people suffering from the syndrome can begin suddenly, last 3-4 days, after which their intensity decreases, they turn out to be mild or fade away altogether. Secondary symptoms of irritable bowel syndrome are associated with the predominant course of the disease.

IBS with diarrhea	IBS with constipation	IBS with flatulence	IBS mixed type
With irritable bowel movements with a predominance of diarrhea, the urge to have a bowel movement appears frequently, usually in the morning or early afternoon, during or after meals.	The syndrome, which occurs predominantly with constipation, is characterized by a delay in defecation for more than three days.	Excessive gas formation caused by fermentation processes in the digestive tract is also a common symptom of irritable bowel disease.	This variant of irritable bowel syndrome is manifested by alternating manifestations of constipation and diarrhea, but the dominant place remains with the pain symptom that passes after the process of defecation.
Frequent bowel movements can provoke emotional experiences, fear, and anxiety.	The feces coming out of the rectum are of a hard consistency, reminiscent of “sheep feces”, and may be mixed with clear, white mucus.	The accumulation of a large mass of gases causes stretching of the walls of the colon, thereby increasing pain.
Secondary symptoms and signs
Pain, swelling in the lateral parts of the abdominal cavity, below the navel, increasing with the urge to go to the toilet, passing after emptying.	Lack of need for food, unpleasant taste in the mouth, heartburn, nausea, stabbing pain along the large intestine, decreasing after a successful trip to the toilet.	Bloating, rumbling, stabbing pain that goes away after the accumulated gases are released.	Spasmodic abdominal pain, a feeling that evacuation is incomplete, mucous discharge from the anus along with feces.

Detecting IBS

It is difficult to diagnose irritable bowel syndrome, so the doctor prescribes extensive diagnostics.

The difficulty in making a diagnosis lies in the absence of characteristic and specific symptoms of irritable bowel syndrome. Studies and tests prescribed to the patient are carried out to exclude other diseases.

The doctor may refer the patient to undergo the following tests and examinations:

• General stool analysis;
• General and biochemical blood test;

A diagnosis of IBS can be made if the above diagnostics do not show signs of other diseases.

The patient's complaints to the doctor are as follows:

• Pain, bloating in the abdomen, which goes away after gases and feces leave the rectum.
• Changes in the nature of the bowel movement: sudden urges, feelings of fecal incontinence, a feeling of incomplete emptying and a full stomach;
• Going to the toilet occurs more often than necessary, with or without diarrhea.
• Constipation, accompanied by heaviness in the abdomen and the need to strain or strain during bowel movements;
• along with feces.
• All IBS symptoms worsen during or after eating.

How and how to treat irritable bowel syndrome?

A healthy lifestyle and good mood are the first sign of the absence of gastrointestinal problems.

The signs of IBS are varied, and the absence of pathological changes in the intestines suggests that treatment of the syndrome should be aimed primarily at suppressing the symptoms that appear.

But before you desperately take medications and pills, it is worth remembering the fact that irritable bowel syndrome is an ailment that occurs first at the level of the head, and not the abdomen. The patient needs to reconsider his lifestyle, learn to cope with stress, keep emotions under control, and not overload the nervous system with worries and fears. If necessary, seek help from a psychotherapist or neurologist.

It is important to adjust your lifestyle in the right direction, walk more in the fresh air, step away from business and relax, adjust your diet, and switch to a dietary, balanced menu.

Treatment of IBS with medications

To treat irritated, inflamed intestines, drugs are prescribed that eliminate unpleasant, painful sensations, normalize motor functions of the intestine, and sedatives.

The choice of the right drug for IBS is determined by:

• accompanying symptoms;
• mental state of the patient;
• variant that predominates in irritable bowel syndrome.

Group of drugs	Name	Action
Antispasmodics	Spasmol, Dibazol, Demitikon, etc.	Reduce the severity of pain symptoms in IBS by affecting the intestinal muscles and enkephalinergic system. The anesthetic relieves intestinal spasm, reduces contractile activity and smooth muscle tone.
Antidiarrheal medications	Enterol, Bisnol, Loperamide, Diarol, etc.	Medicines slow down the intensity of fluid secretion and intestinal motility. Antidiarrheals should not be taken regularly, and not just for irritable bowel syndrome. Can be used exclusively for the symptomatic treatment of IBS.
Laxatives	Citrucel, Laxolin, Granulak, etc.	Constipation in IBS is an indication for the prescription of laxatives. The medicine for constipation softens hardened, stagnant feces and promotes rapid, minimally painless bowel cleansing.
Antidepressants	Eglonil, Imipromin, Befol, Citalopram, Phenelzine.	Medicines used to treat depression and anxiety disorders. The connection between psychological problems and irritable bowel syndrome has been proven, so it is advisable to use drugs designed to calm the patient and his nervous system.
Probiotics	, Bioflor, Enterol, etc.	The occurrence of dysbiosis can complicate the manifestations of irritable bowel syndrome. A lack of the required amount of beneficial microbes and an excess of pathogenic microorganisms lead to exacerbation of IBS symptoms. In this case, the patient is treated with probiotics with antibacterial action, enterosorbents, synbiotics, and prebiotics are prescribed.

Treatment of the syndrome at home with folk remedies

We must pay tribute to traditional medicine; medicinal recipes have a calming effect on irritable intestines and alleviate the main symptoms and manifestations of IBS. Folk remedies can be used for irritable bowels or if it is inflamed, the main condition is consultation with a doctor and compliance with self-medication measures.

Means	Action	Recipe
Walnut decoction	Improves the functionality of the gastrointestinal tract, reduces diarrhea in IBS.	Pour a glass of boiling water over 20 unripe fruits or nut leaves, leave for about 15 minutes, take one tablespoon three times a day.
Aloe and honey mixture	Aloe juice is used in medicine as a laxative, to combat chronic constipation, and as a digestive aid. Helps relieve symptoms of constipation-dominant IBS.	100 gr. aloe leaves, grind until mushy, add 200 g. liquid heated honey and leave for 24 hours. After rubbing through a sieve, discard the waste from the plant, take the finished mixture an hour before meals, 1 tsp.
Peppermint tincture	Peppermint has a calming, regulating effect on the gastrointestinal tract and the central nervous system, which is very useful for irritable bowel syndrome.	Pour two cups of boiling water into two tbsp. l. mint, after 20 minutes of infusion, strain the broth. Drink half a glass 30 minutes before meals, twice a day.
Dill infusion	Dill seeds are effective against flatulence. They relieve symptoms caused by irritable bowel syndrome: pain, colic, and promote the rapid release of accumulated gases.	Pour 250 ml of crushed dill fruits in the amount of a teaspoon. boiling water, leave for 15 minutes, take 2 tbsp. three times a day.

A person diagnosed with IBS must follow a diet, a healthy and active lifestyle. To distract from gloomy thoughts and depression, it is recommended to walk more in the fresh air, do gymnastics, yoga or swimming. An effective way to calm your nerves and find peace is meditation.

Treatment of irritable bowel syndrome does not primarily consist in taking medications, but in a calm rhythm of life that excludes an acute reaction to troubles.

A philosophical approach to solving everyday problems and a positive attitude towards recovery are important. If the intestines are irritated, the above recommendations should be done comprehensively and on the advice of specialists.

Video:

What is irritable bowel syndrome and the most common causes of its occurrence. The main signs and methods of combating this pathology. Types of treatment.

The content of the article:

Irritable bowel syndrome is a pathological condition of the body that is characterized by attacks of abdominal pain and defecation disorders. In order to make a diagnosis, such episodes must be observed for at least twelve weeks over the last year of life. It is also very important to note that all symptoms occur without the presence of any organic problem in the human gastrointestinal tract. This disease mainly affects children, but it can also occur among adults. Moreover, in this case, this condition occurs in an even more severe form.

Causes of irritable bowel syndrome

The presented disease is a huge problem in modern society. Due to the unpleasant negative impact on human life, its etiology is being studied intensively. Despite this, the only provoking factor has not yet been found. There are only a number of causes of irritable bowel syndrome that are most likely to lead to this condition.

Psychological Causes of Irritable Bowel Syndrome

This pathology belongs to a number of diseases that bother a person precisely during periods of unstable emotional state. This suggests that mental health is the soil on which disorders develop. Today they only claim that the presented syndrome has a clear relationship with functional disorders in the patient’s body in the absence of organic changes in tissue and organs.

Pathological conditions such as depression or panic attack most often provoke intestinal irritation. Almost every episode of these diseases is accompanied by stool disorders and a violent reaction from the gastrointestinal tract (gastrointestinal tract).

This condition provokes the mechanism of activation of the autonomic nervous system, because it is the first to respond to mood deviations in one direction or another. Therefore, many patients note that the symptoms appeared during a period of progressive deterioration in their emotional state or at the time of a panic attack.

The main factor that almost always accompanies a person in everyday life is stress. This protective mechanism causes a very violent reaction in the intestines, sometimes even too much. As a result, causeless abdominal pain may appear, which clearly depends on the frequency of exposure to the stress factor on a person.

Neurohumoral causes of irritable bowel syndrome

It is well known that all processes in the body occur under the careful control of the nervous and endocrine systems. These two links control all reactions that occur in the gastrointestinal tract as well. If at any stage such a connection is interrupted and disrupted, then the changes presented will be quite expected.

There are several mechanisms that can lead to this:

• Pathology of nerve connections. In order to ensure normal interaction between brain cells and the points of its application in the intestines, it is necessary to establish their full connection. Often, as a result of any injury or medication, it may be impaired. As a result, regulation will fail and incoming impulses from the cortex will no longer be perceived correctly. This is how the first pathological bowel movements arise in combination with many other disorders.
• Motor impairment. The second mechanism that underlies the development of this syndrome is precisely the slowing down or acceleration of the motor processes of the food bolus. As a result of this, a person begins to experience severe spasmodic pain, which further aggravates the passage of food through the intestinal tube and provokes stool disorders.
• Hormonal changes. Biologically active substances play a very important role in regulating digestion. With their help, many commands are implemented regarding changing the strength and activity of a given process. If any hormone ceases to perform its function, then the entire functioning of the gastrointestinal tract will be disrupted. It was also noted that this disease is more common in women of childbearing age and reduces activity after menopause, which is also associated with the level of hormones in the blood.

Nutritional causes of irritable bowel syndrome

In this group, all the reasons are directly related to the food consumed. This includes various foods and dishes that can have a negative effect on intestinal function.

These include all substances that irritate the mucous membranes: chocolate, citrus fruits, bitters, coffee and strong tea. Particular attention is paid to carbonated and colored sweet drinks. Their influence can, without the presence of any additional factors, independently lead to the development of the first signs of the syndrome.

An important place is occupied by spicy and fatty foods, various types of chips and crackers. Regular consumption of such products can provoke not only a functional disorder, but also mechanical damage to the mucous membrane of the stomach and intestines.

Following the most common harmful substances, it is necessary to mention individual intolerance to certain foods. For many people, the first symptoms of irritable bowel syndrome are associated with the consumption of fermented milk products. Despite the general beneficial effect, many of them can cause disturbances in the intestinal biocenosis. Bacterial flora begins to appear in excess quantities. As a result of this, overly active fermentation processes occur, which causes the appearance of the main symptoms of this syndrome.

Main symptoms of irritable bowel syndrome

The main complaint of people with this disease is the feeling of pain. Very often it is the only symptom of irritable bowel syndrome in a person, but its character is completely different for everyone. Some patients complain of constant aching pain, while others describe it as severe and cramping. Ultimately, it turns out that the diagnosis is the same for both. Often this disease is accompanied by another disorder in the form of stool disorder.

Based on the characteristics of irritable bowel syndrome, there are several variants of its course:

1. With predominance of diarrhea. In this case, most patients complain of severe paroxysmal abdominal pain, which occurs mainly after some kind of emotional shock or stress. There may also be a loud rumbling and noticeable accelerated intestinal motility. After some time, bowel dysfunction occurs in the form of diarrhea. A person has difficulty digesting food, stool appears in the form of liquid lumps with mucus impurities, and pain in the umbilical region may also bother.
2. With predominant constipation. This disorder is more typical for people who are in a state of depressive disorder. Against the background of this pathology, the first symptoms appear in the form of aching pain, a bursting sensation in the abdomen. People gradually reduce the amount they eat and may even go on a hunger strike, which does not bring relief. This type of syndrome is not characterized by the presence of exacerbation attacks. The pathology itself proceeds slowly, without a sharp deterioration in the general condition. Constipation (constipation) also occurs, which is characterized by periodic difficulties and the inability to go to the toilet, followed by the passage of dry and rough feces.
3. Combined option. Some people have a combination of two types of irritable bowel syndrome. They are worried about both retention and increased frequency of bowel movements with almost equal frequency. Periodically, attacks occur, which are replaced by relief or turn into aching abdominal discomfort.

There are also general signs of the disease that are common to all patients. These include migraine-type headaches radiating to the cervical spine. Myalgia, weight loss and mood disorders in the form of suppression are also possible. It is also important to note the fact that all symptoms do not tend to progress, but only periodically recur with the same severity.

Note! These symptoms can also occur with many other diseases. To make a diagnosis, confirmation of a morphological study of the absence of organic pathology of the intestinal tract is necessary.

How to get rid of irritable bowel syndrome

The presence of the described disease significantly worsens the quality of life of a modern person. Despite the fact that there are many ways to treat irritable bowel syndrome, this problem still haunts many people since childhood. The whole problem is that in order to cure, it is necessary to achieve the patient’s complete trust and seek help as early as possible. Due to the fact that people prefer to keep this feature of their digestion a secret or simply refuse medical advice, the disease continues to occupy a place in their lives. To prevent this from happening, a comprehensive approach to eliminating the problem was created.

Psychic therapy

Based on the mechanism of development of this condition, its therapy must begin with the correction of the person’s emotional background. In order to have the right influence, it is necessary, first of all, to assess the general condition of the patient, detect existing disorders, and only after all this begin to choose a treatment option.

Among the wide variety of methods of psychological assistance, two of the most important methods of influence can be distinguished:

• Hypnotherapy. This type of treatment requires careful selection of a competent specialist who, through his sessions, will have a beneficial effect on the patient. This effect is based on immersing the patient in hypnotic sleep to achieve complete relaxation. It is believed that it is at this moment that a person is more inclined to constructive conversations, and is also receptive to recommendations on a subconscious level. The method works quite well, but is preferable only for adults.
• Cognitive behavioral psychotherapy. This group combines almost all other types of psychological assistance. They are based on the organization of individual sessions, during which the doctor conducts an unobtrusive conversation with the patient. Such a conversation is based on the most common questions and reasoning that can reveal the presence of any mental trauma and help in solving it in the future. Even if one is not found, we can recommend several sessions as a preventive measure to teach a person how to deal with stress and share their experiences and emotions. Therapy is indicated for both adults and young children.

Normalization of nutrition

Even after discovering the cause of this syndrome, it is not always possible to eliminate it immediately. While a person is trying to deal with this problem, it is necessary to alleviate his general condition by eliminating the main symptoms. In this case, it is necessary, first of all, to pay attention to the person’s diet.

It should be as nutritious and complete as possible, but not aggravate the situation. To do this, you should drink a sufficient amount of plain water without gas (about 1.5 liters per day), eat food in small quantities about five times a day. Eliminate from your diet foods that are too cold, too hot, or eaten in a hurry.

For patients with predominant diarrhea, it is very important to stop eating raw vegetables and fruits with a laxative effect (apples, grapes, bananas, beans). It is also worth prohibiting fresh juices from the above products. It is recommended to suspend the use of fermented milk products, as well as other fermentation provocateurs (beer, kvass).

In case of constipation, on the contrary, all of the above is recommended. Fresh fruits are good to combine with cereals, bran, nuts, a variety of greens and potatoes are also useful. The consumption of strong tea, coffee and chocolate, which can themselves provoke constipation in a person, is strictly prohibited.

In general, nutrition should be balanced and contain all the necessary microelements. The calorie content of food must be maintained in the range from 2500 to 2900 kcal/day.

Drug treatment

Doctors try to resort to this therapy option as a last resort, but in most cases it is very difficult to do without it. For some reason, such treatment is much better accepted by patients than changing lifestyle and normalizing the emotional background. Medicines have a healing effect much faster and work well in combination with other methods of therapy.

Due to the fact that the syndrome has many causes, various types of drugs are used:

1. Antispasmodics. This group of medications is designed to eliminate the main cause of abdominal pain. Drugs such as “No-shpa”, “Duspatalin” have a pronounced antispasmodic effect and can relieve the patient from suffering within twenty minutes after administration. By relaxing the intestinal muscles, they have a beneficial effect on the movement of the food bolus and prevent fecal retention.
2. Herbal preparations. Such herbal supplements have a general strengthening effect. Sage, valerian, anise and fennel do not have significant side effects. Such substances calm a person, have a positive effect on his emotional state, and also eliminate inflammation. Their use is permissible both in the presence of diarrhea syndrome and constipation.
3. Means that normalize the functioning of the gastrointestinal tract. This includes a very wide range of medicines. Their choice depends on which clinical form predominates in the patient. If a person is concerned about constipation, then the choice is made of various laxatives containing lactulose and sorbitol. The currently known one is Duphalac. But if a patient has diarrhea, it is worth turning to another group of substances that can thicken stool and delay its passage through the intestines. The drugs of choice are Loperamide, Imodium
4. Antidepressants. Such substances are used to ensure the normal psycho-emotional state of the patient. For mild clinical symptoms of depressive disorder, it is recommended to use tricyclic compounds such as Amitriptyline. In a more severe situation with the presence of alarming symptoms, they resort to serotonin reuptake inhibitors, for example, they use Fluoxetine.

How to get rid of irritable bowel syndrome - watch the video:

Before treating irritable bowel syndrome, you need to get confirmation of the diagnosis from your doctor. The thing is that such a pathology can mask many life-threatening conditions, so it is extremely important to make sure that they are absent. When choosing a method of therapy, you should remember the preferred combination option with mandatory diet therapy.

Flatulence, cramps and abdominal pain, bloating, diarrhea, constipation are common digestive system disorders, which doctors call irritable bowel syndrome (IBS).

The condition is not life-threatening and does not lead to the development of serious pathologies, such as ulcerative colitis, Crohn's disease or colorectal cancer. But IBS can be a long-term problem that negatively impacts quality of life and often leads to depression.

Causes of the syndrome

The exact cause of the disorder is unknown. Its development is believed to be associated with a number of factors, including:

• Impaired intestinal motility. The muscular layer of the organ provides contractions, peristalsis, and rhythmic segmentations that move food through the digestive tract and into the large intestine. When motor function is impaired, irritable bowel syndrome occurs: increased peristaltic movements cause flatulence, bloating and diarrhea, and weak contractions slow down the passage of food, which leads to hard, dry stools.
• Intestinal infections. In 30% of cases, IBS is caused by acute viral or bacterial infection of the stomach and intestines, which contribute to the production of pro-inflammatory cytokines. The formation and release of these specific proteins causes increased organ permeability, leading to bacterial translocation of commensals across the epithelial barrier. They move freely into the internal environments of the body, causing damage to local tissues, causing chronic intestinal disorders.
• Increased excitability of the nervous system. It has been proven that pathology often develops against the background of a psychoemotional disorder, when a person is under stress for a long time. In this case, a vicious circle is observed: IBS is the result of traumatic events, and the symptoms of the syndrome in question further aggravate the patient’s depressive state.
• Hormonal imbalances. In women, signs of the disease are more common than in men. This is explained by an episodic increase in the level of prostaglandin E in the blood in the last and first days of the monthly cycle. Pregnant women and women at the onset of menopause also note the presence of IBS symptoms.
• Lack of power control. Irritable bowel syndrome often develops in people who eat high-calorie, spicy and fatty foods. Drinks that can cause this disorder include alcohol, soda, strong tea or coffee. Many patients note a deterioration in their condition while taking dairy products, citrus fruits, legumes, cereals and fiber.
• Genetic predisposition. The existence of such problems in the family increases the risk of developing IBS in the younger generation.

Symptoms of Irritable Bowel Syndrome

Manifestations of IBS in adults and children are similar to signs of a digestive disorder. Therefore, only a doctor can differentiate the disease based on the results of a comprehensive examination. The most common symptoms of the condition:

• Pain, cramping, or bloating that is usually relieved by bowel movements or bowel movements.
• , flatulence.
• Diarrhea or constipation, sometimes alternating.
• Mucus in stool.

For most people, irritable bowel symptoms periodically subside, become severe, or disappear for a while. Other victims show serious symptoms:

• Weight loss.
• Diarrhea at night.
• Rectal bleeding.
• Iron-deficiency anemia.
• Unexplained vomiting.
• Difficulty swallowing.
• Constant pain that is not relieved by passing gas or bowel movements.

Diagnostics

Video: Irritable bowel syndrome: symptoms and treatment

The appearance of suspicious symptoms is a reason to contact your family doctor or therapist. You may need to consult a gastroenterologist, who will determine the exact cause of the ailment and select the right medications for treatment.

Irritable bowel syndrome is diagnosed by ruling out other digestive disorders that may cause similar symptoms. To determine the duration and frequency of manifestations, the clinical history of the disease and the physical condition of the victim are taken. A doctor can talk about irritable bowel syndrome only when the symptoms last for at least six months and they occur at least three times a month.

To exclude other serious pathologies, a comprehensive examination is carried out:

• Blood test (general and biochemistry).
• Coprogram of feces.
• Sigmoidoscopy or irrigoscopy.
• CT scan.
• Intestinal biopsy.

Diet and lifestyle changes as a method of treating the syndrome

The first step towards alleviating the patient’s condition is correcting the diet. Excluding certain foods from the daily menu can reduce the severity of IBS symptoms, and in some cases, get rid of the problem altogether. To identify these “food irritants,” it is recommended to keep a food diary.

Products that relieve the condition:

• Dishes with reduced fat content.
• Cereals, cereals and grain products.
• Fermented milk products (sourdough, kefir, fermented baked milk).
• Pure water.
• Probiotics (with Lactobacillus acidophilus and) and prebiotics.

If constipation predominates in IBS, the patient is prescribed a diet with a high fiber content. The recommended daily fiber intake is 20–35 grams. In the absence of a laxative effect, you need to increase their amount in the diet gradually so as not to provoke increased formation of intestinal gases.

Video: House Doctor: Irritable Bowel Syndrome

Products that should not be consumed if you have the syndrome:

• Lactic acids, including milk and cheese (symptoms of lactose intolerance may be similar to those of IBS).
• Certain vegetables that increase gas (for example, cauliflower, cabbage, or Brussels sprouts, broccoli, beans).
• Fatty or fried foods.
• Alcohol, caffeine or soda.
• Foods high in sugar.
• Artificial sweeteners.
• Chewing gum.
• Nuts.

Low FODMAP Diet

For this syndrome, a diet limited in fermentable monosaccharides and polyols (FODMAPs) may be used. These short-chain carbohydrates are poorly absorbed in the small intestine and are quickly fermented by bacteria, which produce gas and cause IBS symptoms.

The FODMAP group of substances includes:

• Lactose (source: cow, goat and breast milk).
• Fructose (honey, fruit, corn syrup).
• Fructans (onions, garlic and wheat).
• Galactans (beans, beans, lentils).
• Polyols (mushrooms, some vegetables and fruits, sweeteners and drugs).

Lifestyle change

In addition to correcting your diet, developing the following habits will improve your condition and alleviate the symptoms of irritable bowel disease:

• Eat in smaller portions, but more often, up to 6–8 times a day.
• Stop smoking.
• Exercise regularly (yoga, tai chi, swimming, walking).
• Avoid caffeine.
• Use stress management techniques.
• Develop mindfulness.
• Practice meditation.
• Relieve pain when it appears.
• Take probiotics (Bifiform, Subalin, Linex).
• Get enough sleep; sleep should last at least 8 hours.
• Avoid laxatives unless otherwise directed by your doctor.

Drug treatment for irritable bowel syndrome

Video: Irritable bowel syndrome. Disease of young women

When dietary restrictions and lifestyle changes do not bring relief, the doctor prescribes drug therapy using laxatives and antidiarrheals, antidepressants, antispasmodics and antibiotics.

IBS with diarrhea

• Antidiarrheal agents such as Loperamide (Imodium), Attapulgite, Diphenoxylate, Atropine (Lomotil) will be useful if one of the main signs of digestive distress is weak stools.
• Antibiotics such as Rifaximin are used when the treatment of irritable bowel syndrome is aimed at combating diarrhea and distension of the peritoneum.
• Bile acid sequestrants are necessary to eliminate excess bile from the intestines. Among these drugs are Cholestyramine and Colestipol.
• Sorbents for removing toxic compounds – Enterosgel, Sorbex, Filtrum.
• Herbal decoctions based on the peel of alder, bird cherry, walnut leaves, pomegranate fruits, cherries, blueberries, and serpentine root.

IBS with constipation

• Over-the-counter laxatives – Polyethylene glycol 3350 (Miralax), Bisacodyl (Dulcolax) and Metamucil (psyllium husk based). They help relieve constipation and keep bowel movements regular. Preparations with senna (Senadex, Senadexin) can be taken for a short time. Prescription laxatives such as Lactulose are also prescribed.
• Two drugs specifically used to treat IBS with constipation are Lubiprostone and Linaclotide. They are used to relieve abdominal pain, bloating and impaired intestinal motility.
• SSRI antidepressants - Fluoxetine, Sertraline, Paroxetine, Citalopram and Escitalopram. Such drugs are beneficial for constipation, but can aggravate the condition of patients with diarrhea.
• Herbal decoctions based on yarrow, licorice root, buckthorn bark.

What medications relieve pain and spasms?

• Antispasmodics such as Metoclopramide, Dicyclomine and Hyoscyamine reduce the severity of painful discomfort and cramps.
• Defoamers - Espumisan, Maalox, Pelsan - are designed to destroy gas bubbles in the intestines, which are the provocateur of painful sensations.
• Antidepressants - Amitriptyline, Doxepin, Desipramine, Nortriptyline and Imipramine help with abdominal pain, but due to side effects are usually reserved for severe cases.
• Herbal products - anise drops, valerian root, chamomile, peppermint, dill or fennel seeds.

Therapeutic exercises for IBS

Regular exercise in the fresh air will help make your intestines work properly. It is the free flow of oxygen into the body that calms the nervous system, which coordinates the work of the digestive tract. Therefore, psychological relaxation in a natural environment helps reduce IBS symptoms. Cycling, walking, and yoga classes for 30–60 minutes 3–5 times a week will allow you to achieve a therapeutic effect.