How to control irritable bowel syndrome and reduce symptoms

Irritable bowel syndrome (or irritable bowel syndrome/IBS) is a common occurrence in the population and a functional gastrointestinal disorder at the colon level. The colon is apparently healthy, but a set of unpleasant symptoms can seriously affect the patient’s quality of life.

Irritable bowel syndrome: What the clinical picture looks like and what is needed to confirm the diagnosis

– The main characteristic of the clinical picture of these patients is abdominal pain, which stops when the patient goes to the toilet and defecates in the form of diarrhea. Therefore, there is a change in the consistency of the stool. It is the most common and unquestionable symptom that, in order to confirm the diagnosis with an individual approach to each patient, should be present for at least six months. Since there are no biomarkers for irritable bowel syndrome, the gastroenterologist evaluates the clinical picture and makes an adequate choice of diagnostic methods, i.e. the type of laboratory tests for blood and stool, as well as endoscopic examination. In the case of a diagnosis of this functional disorder, we first assure the patient that it is a harmless problem in the sense of life-threatening. Then a relationship of trust is built, which will give the best results with the best mode of therapy (primarily non-pharmacological, if necessary also pharmacological measures or a combination). The goal is to reduce symptoms and maintain the quality of life at a satisfactory level – he explains in an interview for eClinic portal assistant professor Srđan Markovićgastroenterologist from the IBD center at KBC Zvezdara.

Pain as a dominant symptom

It is estimated that due to dysfunction of one of the organs of the digestive tract, every fifth person has gastrointestinal problems in the form of flatulence, gas in the abdomen, diarrhea, and constipation. According to Assoc. Dr. Marković, if there are similar complaints, you should first pay attention to alarm symptoms such as blood in the stool, anemia, weight loss, family history of colon cancer… Patients over 50 should also react if they have these manifestations.

Interlocutor eClinic portal says that bloating and gas are seen in more than 50% of IBS patients. The presence of chronic pain and cramps in the lower abdomen is predominant. This pain tends to “walk” around the abdominal region. It is most often provoked by a certain meal and is definitely alleviated after emptying, according to Assoc. Dr. Marković.

What are the other possible symptoms when someone has irritable bowel syndrome?

Asst. Dr. Marković also describes that when this disorder exists, bowel habits change, so someone can also have constipation, or combined symptoms (diarrhea and constipation). Heartburn, mild nausea, feeling of a “stone” in the stomach, difficult or poor digestion, uncontrollable intestinal spasms, (“gurgling”), frequent belching may also be present. Some patients also experience frequent urination, and psychological symptoms (nervousness, anxiety, fear) are often expressed. The gastroenterohepatologist emphasizes that IBS patients most often have the described complaints in the morning, after waking up. But as he says, not everyone has to have all the symptoms, and if only one is present, it is most often done in flatulence.

How to treat irritable bowel syndrome

The path from symptoms to diagnosis and adequate therapy is sometimes challenging for both the patient and the doctor. It happens, confirms Assoc. Dr. Marković, to change several gastroenterologists, which increases the stress of the sick person because the symptoms persist.

– In addition to understanding by the doctor, an individual approach is necessary: ​​to adjust the therapy individually to each patient. Sometimes certain antibiotics are used, but it should be said that the use of pharmacological measures often involves the use of several drugs (up to 6 or 7) and is far from an ideal approach. Certainly, our first recommendation for patients with irritable bowel syndrome is a hygienic-dietary diet. It is known that certain foods are often a trigger for worsening symptoms. In most cases, these are cereals (wheat), dairy products, legumes, citrus fruits, cabbage, beans, as well as the consumption of alcohol and carbonated drinks. – states our interlocutor and specifies:

Why is it important for the doctor to suggest an appropriate diet and for the patient to implement it adequately?

– There are several models of nutrition that can give a good result. One of the most commonly recommended is the so-called FODMAP diet, which implies the restriction of non-fermentable monosaccharides. In general, we advise a diet with low fat content, without concentrated carbohydrates, i.e. simple sugars, sweets, while avoiding foods that cause bloating, spicy and hot foods and minimal consumption of caffeine and alcohol. All foods that are not pleasing should be removed from the menu. Here, too, both parties should be careful, and doctors should be especially careful in their recommendations. Namely, it happens that patients overdo it in an overly restrictive regimen, and weight loss occurs. This then requires additional diagnostics where we usually find nothing, the patient suffers and ends up at a psychiatrist. Although there are controversial conclusions, there are enough randomized clinical studies that confirm that the FODMAP diet can reduce symptoms in IBS patients – says Dr. Marković.

Probiotics and gluten

The doctor adds that there are clear differences between the microbiota of IBS patients and those with healthy guts, and that probiotic supplements, prebiotics and symbiotics (a combination of these) also contribute to improvement. Alternative methods such as phytotherapy (peppermint oil, for example) should not be ruled out either, but under the supervision of a gastroenterologist. A gluten-free diet is recommended for some patients even though they do not have celiac disease, as this has also been shown to affect symptoms.

Stress and a fast-paced lifestyle are often triggers for irritable bowel syndrome

Irritable bowel syndrome is one of the most common diseases of modern humanity, and the fast-paced lifestyle and stress are some of the main triggers that worsen the symptoms. The patient, although it is not easy for many because of the discomfort of the symptoms, should be as relaxed and casual as possible, and let the bowels accommodate the influences of the external environment.

– Nervousness, anxiety, fear and uncertainty often lead to bloating, cramps, gas and irregular bowel movements. In addition, patients with this syndrome most often have visceral hypersensitivity and intestinal barrier dysfunction. What is an inseparable part of the therapy and what will also help is mandatory physical activity. Whether it is yoga, swimming or something else that will make the patient’s comfort zone more stable, is again individual. Nervous bowel complaints (irritable colon) usually appear or worsen during or after a period of stress and emotional tension – he explained in an interview for eClinic portal Assoc. Dr. Srđan Markovićgasteoenterohepatologist.

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