Irritable Bowel Syndrome
A common condition, IBS (including spastic colon, spastic colitis, and mucous colitis) is marked by chronic or periodic diarrhea alternating with constipation. It’s accompanied by straining during defecation and abdominal cramps.
Although IBS was once thought to occur primarily in females, the number of males diagnosed with the condition is increasing.The symptoms typically emerge before age 40, and the prognosis is good. (See IBS in males.)
Causes
Although the precise etiology is unclear, irritable bowel syndrome involves a change in bowel motility, reflecting an abnormality in the neuromuscular control of intestinal smooth muscle.
Contributing or aggravating factors include anxiety and stress. Initial episodes occur early in life; psychological stress probably causes most exacerbations. Irritable bowel syndrome may also result from dietary factors, such as fiber, fruits, coffee, alcohol, and foods that are cold, highly seasoned, or laxative. Other possible triggers include hormones, laxative abuse, and allergy to certain foods or drugs.
Gender differencesIBS in males
Irritable bowel syndrome was long considered more prevalent among females, largely due to research studies indicating that females accounted for 70% of those diagnosed with the condition. It’s now believed, however, that IBS occurs in just as many males as females, a theory based on several factors.
The incidence of IBS in males may be underreported because men are less likely to seek medical attention than females. Less research has been done on the incidence of IBS in males, adding to the belief that the condition is more common in women. Furthermore, clinical trials of medications developed for the treatment of IBS have commonly consisted of cohorts of females. For example, Zelnorm (tegaserod maleate) is indicated for the short-term treatment of females with IBS whose primary bowel symptom is constipation.
Complications
Irritable bowel syndrome is associated with a higher-than-normal incidence of diverticulitis and colon cancer. Although complications are usually few, the disorder may lead (rarely) to chronic inflammatory bowel disease.
Because symptoms mimic those of acute abdomen, misdiagnosis occasionally results in unnecessary surgery.
Assessment
Typically, the patient reports a history of chronic constipation, diarrhea, or both. She may complain of lower abdominal pain (usually in the left lower quadrant) that’s often relieved by defecation or passage of gas. She may report bouts of diarrhea, which typically occur during the
day. This symptom alternates with constipation or normal bowel function.
day. This symptom alternates with constipation or normal bowel function.
The patient may describe her stools as small with visible mucus. Or, she may have small, pasty, and pencil-like stools instead of diarrhea. Other common complaints include dyspepsia, abdominal bloating, heartburn, faintness, and weakness.
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