IRRITABLE BOWEL SYNDROME
• Irritable bowel syndrome (IBS) is a benign, chronic symptom complex of altered bowel habits and abdominal pain.
• No organic cause can be found.
• Altered GI motility occurs in the form of exaggerated gastrocolic reflex, altered gastric emptying, increased small bowel contractions and increased small intestinal transit.
• Neurotransmitters such as serotonin may be an important factor.
• Psychological disturbances like anxiety, tension and excessive worry are all aetiologically significant.
• Certain foods may precipitate an attack.
• Three clinical variants:
• Those with spastic colitis, having primarily chronic abdominal pain and constipation (IBS with constipation or constipation-predominant IBS-at least 25% of stools are hard and fewer than 25% are loose or watery).
• Those with chronic intermittent, watery diarrhoea often without pain (IBS with diarrhoea or diarrhoea-predominant IBS-at least 25% of stools are loose or watery and fewer than 25% are hard).
• Those with both features and alternating diarrhoea and constipation (mixed IBS-at least 25% of stools are loose or watery and at least 25% are hard).
• More common in females of the age group 20-40 years.
• Abdominal pain is the most common symptom. Pain is referred to left or right iliac fossa or hypogastrium.
• Pain often provoked by food and relieved by defecation.
• Diarrhoea is often painless, occurs in the morning but never at night.
• In constipation-predominant IBS, stools are described as pellet like, ribbon like or pencil like.
• Mucus may or may not be present.
• Postprandial tenesmus is common, due to an exaggerated gastrocolic reflex.
• Other symptoms are abdominal distension, feeling of incomplete evacuation of rectum, excessive flatus, dyspepsia, heart burns, frequency and dysuria.
• Prime aim of investigations is to exclude organic bowel diseases.
• Stool examination for leucocytes, parasites, ova, and occults blood
• Routine testing for coeliac disease is advisable
Large amounts of mucus may be seen. Bowel shows marked motor activity
• Barium enema-Usually normal.
• Exclude lactase deficiency, hyperthyroidism and alcohol abuse.
• Reassurance of the patient and explanation for the symptoms.
• Increase the roughage content of the diet and add a bulk laxative
TREATMENT AT DR. SOHAN LAL CLINIC
The integrated POLYCLINIC facility offers patients to select their treatment either from the Department of Homeopathy or from the Department of Medicine.
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