Irritable bowel syndrome also called Spastic disease has long been classified by clinicians as Functional Gastrointestinal disease. In the era of modern medicine where clinicians love to find cure for organic diseases with specific pattern of clinical features and diagnostic criteria with positive imaging findings, IBS is more of functional problem.
The cause of IBS is uncertain but is likely to be multifactorial. IBS is a disorder of defective regulation of brain-gut axis, involving abnormal function in the enteric, autonomic and/or central nervous system (CNS). It is due to body’s over reaction to nerves located in our body both peripheral and central system to variety of inflammatory and non inflammatory substances. Resulting to this, the motility of bowels increases which is one of the cardinal feature of this disease complex. Based on symptoms, IBS is categorised as
- Diarrhoea predominant
- Constipation predominant
- Mixed diarrhoea and constipation
- Alternating Diarrhoea and constipation
PELVINIC’S WAY OF MANAGEMENT OF IBS
After careful history taking, general examination and looking for alarm features (weight loss, rectal bleeding, nocturnal symptoms, anemia, family history of colorectal cancer, IBD) Dr Banerjee and team arrives at the diagnosis. Full work up of these patients are done which include complete blood count (CBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) initially. At Pelvinic stool is sent for routine microscopic examination. Routine thyroid function test (TFT), colonoscopy and diagnostic imaging are not advised unless there are alarm features.
The treatment for diagnosed patients include a combination of medical management, psychological help and counselling and other supportive medications. Need for surgery arises in case of any complications. Irritable bowel syndrome is a chronic relapsing disorder characterized by recurrent symptoms of variable severity. The life expectancy, however, remains similar to that of the general population. IBS does not increase the mortality or the risk of inflammatory bowel disease or cancer. The principal associated physical morbidities of IBS include abdominal pain and lifestyle modifications related to altered bowel habits. Absenteeism from work resulting in lost wages is more frequent in patients with IBS.