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IBS

They are known as irritable bowel syndrome or irritable bowel syndrome or bowel syndrome irritable and Acronym (IBS), which is also referred to as spastic colitis , colon spastic and inflammation of the colon mucosa colitis: is defined as a chronic disorder that occurs in the gastrointestinal tract, and most of the time the effect lies in the large intestine, which is also called the colon, and in fact the word syndrome refers to a group of conditions or symptoms that meet and occur in Same time, According to the Journal of the Hellenic Society of Gastroenterology, which published an article about a study conducted on the epidemiology of Irritable Bowel Syndrome in 2015, it showed that the prevalence of Irritable Bowel Syndrome is 11.2% worldwide.
It is worth noting that sometimes there may be an overlap in the names between Irritable Bowel Syndrome and Colitis, which involves damage to the colon itself, as it is a more serious condition than Irritable Bowel Syndrome that does not lead to any damage or damage in Colon.

Types of Irritable Bowel Syndrome

There are many types of irritable bowel syndrome, as it can be divided into four different types that can be explained as follows:

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Irritable bowel syndrome accompanied by diarrhea ( IBS-D), in which the patient may feel an urgent need for excretion, and this is accompanied by suffering from the emergence of cramps and feeling pain in the stomach.
Irritable bowel syndrome accompanied by constipation (IBS-C), which may cause a lack of bowel movement, or the patient may feel an urgent urge to pass with difficulty and the inability to do so.
Irritable bowel syndrome accompanied by both diarrhea and constipation .
Irritable Bowel Syndrome Nonspecific Symptoms.

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Irritable Bowel Syndrome

Irritable bowel syndrome symptoms differ from one person to another, it is possible that all symptoms develop in the patient or part of them may appear, and it is indicated that this condition may be interspersed with the presence of a normal movement of the intestine for several days, and the symptoms are usually of mild severity in most patients, However, there are some people who may suffer from severe symptoms that affect their daily life. In this context, it is indicated that irritable bowel syndrome usually begins to develop in puberty, and irritable bowel syndrome is more common in women compared to men, and it often increases in severity. Symptoms are worse during the menstrual cycle , It should be noted that changes in bowel function are common during pregnancy, which may cause the suffering of symptoms.

Common Irritable Bowel Syndrome

There are many common symptoms of IBS, and the following are mentioned:

Abdominal pain and cramps: Abdominal pain and cramps are among the main symptoms associated with IBS, and pain and discomfort may occur in different parts of the abdomen, and it may be in the form of cramps or cramps, and this pain usually occurs in the form of attacks that come and go, and the length and intensity of each attack may differ As for the other attack, the pain is often less severe when passing out or releasing gas .

Change in bowel movement: A change in the nature of bowel movement is one of the common symptoms associated with irritable bowel syndrome, and this may be the suffering of diarrhea, constipation, or alternating bouts of both, and diarrhea associated with irritable bowel syndrome is represented by frequent loose stools, and this often happens In the early morning or after eating meals, and often this situation is preceded by a feeling of intense urgency and followed by a feeling of incomplete emptying, but in the case of constipation it is often represented by the release of hard stools, so that this is intermittent and continues for several days, and usually the patient does not feel completely emptied If the rectum is empty, then sitting on the toilet for long periods of time may result.

Bloating: The patient feels fullness in the abdomen accompanied by a feeling of discomfort.

Other IBS symptoms

There are other symptoms that may result from IBS, and some of them are mentioned below:

Problems with urination; Such as the need to urinate frequently, the feeling of a sudden need to urinate, the feeling that the bladder is not emptied completely, and the inability to control the bladder at all times.

Back Pains.

Nausea .

Headache head.

Fatigue and tiredness.

Pain during the exercise of the marital relationship for women.

Bad breath.

Anxiety and depression associated with passing out and feeling uncomfortable with other IBS symptoms.

Irritable Bowel Syndrome that warrants medical intervention

Regardless of the severity of symptoms, the person should see a doctor if he suffers from IBS symptoms in order to confirm and confirm the diagnosis, and it is indicated that there are no specific tests confirming the diagnosis of this condition, and to confirm the diagnosis, the doctor asks questions related to the person’s general health and inquires about the nature of the symptoms that He complains about it, and it may require a person to undergo a rectal examination in some cases, but there are some signs and symptoms that may accompany this condition and require medical intervention, as these symptoms may not be caused by irritable bowel syndrome, but may be associated with some other problems. The most serious and requiring immediate medical intervention, and we mention of the symptoms that require a visit to the doctor as follows:

Unexplained weight loss.
Blood in the stool.
Fever .
stomach bloating.
Vomiting Persistent pain.
Signs that may indicate anemia.
Bladder problems or associated signs; Such as the need to wake up to urinate at night, the feeling of an urgent need to urinate and difficulty emptying the bladder completely.
Urinary incontinence

Types of Irritable Bowel Syndrome

The condition of Irritable Bowel Syndrome has been classified into several main types based on the patterns of different bowel movement changes, and it is worth noting the importance of knowing the type of Irritable Bowel Syndrome and therefore to determine the appropriate treatment plan for the condition, and in this context it is indicated that some types of drugs only work with certain types of Irritable Bowel Syndrome without Other types, and certain types may worsen if used. The four types of Irritable Bowel Syndrome can be explained as follows:

The prevailing pattern of constipation, which alternates with the normal movement of the intestine, this type is often accompanied by pain and cramps in the abdomen when eating.
The prevailing pattern of diarrhea, and in this case a person often experiences diarrhea in the morning or after eating.
Alternating pattern between diarrhea and constipation.
Irritable Bowel Syndrome, which is not classified as having symptoms that cannot be classified into any of the three types mentioned above.

Triggers for the emergence of Irritable Bowel Syndrome

There are many factors that increase the likelihood of irritable bowel syndrome, which are called irritable bowel syndrome, and by avoiding these triggers, it is possible to reduce the likelihood of irritable bowel syndrome. The following are some of these triggers:

Food: Food is one of the most important triggers for IBS symptoms, and although the role of food sensitivity or intolerance in the emergence of irritable bowel syndrome is not fully understood, the nature of the food that is eaten is considered one of the most important triggers for IBS symptoms for many people. Some of the stimulating foods associated with this condition are listed below:

Foods that stimulate constipation: Eating certain foods may worsen constipation associated with irritable bowel syndrome. These foods include refined grain bread and processed foods, as well as coffee, soft drinks, alcohol, and some dairy products. Especially cheeses, in addition to that a diet rich in protein may play a role in this, and there are some tips that can be followed to avoid constipation associated with irritable bowel syndrome, such as increasing the amount of fiber. Which is eaten gradually, increasing by two to three grams per day until the amount of fiber consumed reaches 25 grams for women and 28 grams for men per day, and fiber can be obtained from whole grains, beans, fruits and vegetables, in addition to eating moderate amounts of foods Which contain a high percentage of sorbitol sugar, such as dried plums, and it is worth remembering to drink adequate amounts of water daily.
Foods that trigger diarrhea: There are many foods that make diarrhea associated with irritable bowel syndrome worse in some people. Such as eating large amounts of fiber, especially the insoluble fiber found in the peel of fruits and vegetables, in addition to eating chocolate, or drinking alcohol or caffeine., Or drinks that contain fructose or sorbitol, or soft drinks, and eating large meals at once may play a role in that, and from foods that stimulate diarrhea we mention fried and fatty foods, and some dairy products, especially for people who suffer from dyspepsia of sugar Lactose in milk, and eating some foods that contain wheat may make diarrhea worse, especially in people who suffer from gluten sensitivity, and people who suffer from diarrhea associated with IBS can follow some tips to reduce the incidence of diarrhea, such as eating a moderate amount of fiber sources Soluble; Such as whole wheat bread, oats, barley, brown rice, pasta and dried fruits, and it is also advised to avoid eating foods with opposite temperatures during the same meal. Such as eating cold water and hot soup at the same time, and it is worth avoiding eating foods that cause gas or Make it worse; Like broccoli, onions, and cabbage, it is also recommended to drink water at least an hour before a meal or after that, so that it is avoided to drink water while eating.

Tension and stress: Stress and tension play a role in stimulating the development of irritable bowel syndrome in some people or making these symptoms appear worse, and it should be noted that stress and tension in themselves may cause an exacerbation of irritable bowel syndrome, but it does not lead to irritable bowel syndrome Directly, stress can arise from work problems, family or financial problems.
Taking certain medications: Taking some medications may stimulate constipation or diarrhea as a side effect of their use. Such as antibiotics , some antidepressants, and some medicines that contain sorbitol; Like some cough medicines.
Hormonal changes: Hormonal changes play a big role in stimulating the suffering of irritable bowel syndrome symptoms, especially for women, as many women find that IBS symptoms worsen during menstruation.

The difference between irritable bowel syndrome and inflammatory bowel disease

As mentioned earlier, irritable bowel syndrome is not a disease in itself, but rather a disturbance in bowel function, and irritable bowel syndrome and inflammatory bowel disease may have some similar symptoms, but irritable bowel syndrome is less dangerous than inflammatory bowel disease, as Irritable Bowel Syndrome does not cause inflammation Or bleeding in the intestine or rectum, or an ulcer, and it does not cause permanent damage to the intestine that can occur when infected with inflammatory bowel disease.

Causes and risk factors of IBS

The main underlying cause of irritable bowel syndrome is still unknown, but both women and people under the age of 50, as well as people with a family history of irritable bowel syndrome, are more likely to have this syndrome, and It is worth noting that the intestine passes food through regular contractions of the muscles in its walls, and in cases where these contractions are abnormal or overactive, the sufferer will feel pain and notice the appearance of symptoms associated with Irritable Bowel Syndrome, and it should be noted that the reasons for the irregularity of these contractions are not clear despite the presence of Many factors contribute to its irregularity, and among these factors are the following:

Overactivity of nerves or muscles in the intestine, and this happens for several reasons, as excessive messages sent from the brain to the gastrointestinal tract may have a role in this, in addition to exposure to tension and anxiety, as patients with Irritable Bowel Syndrome notice that symptoms worsen when exposed to anxiety and tension, However, the main cause of overactive nerves or muscles in the intestine is still unknown.
Sensitivity to some types of food, but this factor was found in a small number of sufferers.
Having an intestinal infection.
Viruses , bacteria and germs that cause an infection in the intestine may trigger symptoms of irritable bowel syndrome. Increased sensitivity to pain, as people with irritable bowel syndrome feel pain faster than people without problems when their intestines expand.

Diagnosis of IBS

The doctor seeks to monitor the symptoms that the patient suffers from when diagnosing irritable bowel syndrome, in addition to conducting clinical examinations of the abdomen to detect any swelling, pain or abnormal sounds in it, and the patient is also asked many questions related to symptoms and whether they improve or worsen after The excretion, the number of times and the nature of the excretion, because there is no specific examination to detect irritable bowel syndrome, and it is worth noting that irritable bowel syndrome can be diagnosed if the patient suffers from symptoms every week for three consecutive months, and provided that these symptoms began to appear before six Months, The following is mentioned some of the laboratory and radiological examinations that the doctor may conduct to exclude any other health conditions that may cause symptoms similar to Irritable Bowel Syndrome:

Blood tests: The doctor usually conducts a blood test to exclude other conditions, such as: anemia, infection, and gastrointestinal diseases.
Stool examination: The stool examination helps the doctor to detect the presence of blood or any other signs indicating the presence of infection.
Colonoscopy: It is usually performed to detect the presence of diseases, such as: colon cancer or irritable bowel disease.

It is worth noting that after conducting the aforementioned analyzes and ruling out other health conditions, the doctor uses the Rome criteria to detect irritable bowel syndrome, and these criteria include feeling abdominal pain and discomfort that lasts on average for one day At least a week during the previous three months, and this feeling is accompanied by at least two of these factors, namely: a change in the consistency of the stool, or a feeling of pain and discomfort associated with defecation, or a change in the number of times defecation.

Drug treatment for IBS

People with Irritable Bowel Syndrome can resort to medical treatments to alleviate the severity of symptoms and improve the health of the patient, due to the lack of effective medical treatment for the disease itself, and the choice of appropriate treatment depends on the severity of the symptoms. Symptoms of light are usually treated by making some changes to lifestyle and diet and avoid exposure to stress and stress -seetm addressed in detail in Almqal-, but in cases where the symptoms are the more severe MUST consult your doctor, especially if the patient is suffering from depression or If exposure to stress increases the severity of symptoms.

Irritable bowel syndrome with constipation

Irritable bowel syndrome accompanied by constipation is one of the most common types of irritable bowel syndrome, and it affects about a third of people with irritable bowel syndrome, and it is represented by the presence of a chronic condition of constipation associated with feeling pain in the abdomen, and in fact it can be said that the individual suffers from constipation when the stool is hard Stool excretion, as the number of times a stool is passed less than three times a week, and the individual may feel that not all intestinal contents are expelled at times. What follows is a mention of the most important treatments used to treat irritable bowel syndrome accompanied by constipation:

Block-forming laxatives: These laxatives help to slow the movement of food within the digestive system and thus may reduce symptoms of constipation, examples of these laxatives include psyllium, wheat bran, and corn fibers.
Stool softeners: These drugs are usually the first choice for treating colon constipation, and this is due to the consideration that these laxatives are relatively safe, as they are widely available and inexpensive, and the principle of their work is based on stimulating bowel movement, and we mention some of the following types These laxatives:

Osmotic laxatives: These drugs work to re-draw water into the colon, which reduces the hardness of the stool and facilitates its excretion from the person’s body. It should be noted the importance of making sure to drink plenty of water when using this type of laxative to avoid suffering from Drought.
Stimulant laxatives: These laxatives stimulate the muscles around the intestine, which contributes to an increase in pressure on the waste, which leads to the movement of waste through the colon, and it should be noted that it is advised not to use this type of laxatives regularly. This is because the continuous use of this type of laxative leads to the body becoming accustomed to it and thus its inability to complete the excretion process naturally without using it.

Substances that increase excretion: The action of these drugs is to increase the water content of both stool and intestine, which leads to an increase in bowel movement and make it more frequent. These drugs are among the most recent drugs used to treat irritable bowel syndrome associated with constipation, and the following is a statement For these drugs in some detail:

Lubiprostone: This drug can be used to treat severe constipation and IBS in women over the age of 18. Specifically, those who have not responded to other treatments, and the principle of action of lubiprostone depends on promoting secretion through chloride channels in the intestine, which in turn enhance muscle contractions in the digestive system, which leads to pushing its contents through the digestive system, and it is recommended to take this drug Regularly according to the doctor’s instructions in order to fully obtain the benefit, and it is preferable to take the medicine at the same time daily by mouth after eating with a glass of water, with emphasis on swallowing the pill whole and avoiding breaking it or chewing it.
Linaclotide: Linaclotide is used to treat Irritable Bowel Syndrome accompanied by constipation in people over the age of 18 who have not responded to other treatments, and its principle of action depends on increasing the movement of the contents of the digestive system, and it prevents the feeling of pain resulting from bowel movement.

Irritable bowel syndrome with diarrhea

Some sufferers can suffer from IBS with diarrhea. It is represented by a sudden and urgent movement in the intestine, which leads to making the stool appear soft and watery. People with this condition can be treated with the following drugs:

Anti-diarrheal medicines: There are many anti-diarrheal medications, some of which require a prescription while others do not. In the following, the most important of these medicines can be explained in some detail:

Loperamide: Loperamide is an over-the-counter anti-diarrheal drug that works on reducing the flow of fluids and electrolytes into the intestine as well as slowing down the bowel movement, which reduces the number of intestinal movements, thus regulating the passage of food through the digestive system. Therefore, it can help to cope with diarrhea in people with IBS that is accompanied by diarrhea. Loperamide is available in the form of pills, capsules, suspensions, or a liquid solution taken by mouth.
Bile-acid binders: These substances help reduce bowel movement, thus making the stools more solid.

Rifaximin: An antibiotic such as Rifaximin can be used to treat Irritable Bowel Syndrome accompanied by diarrhea, because it affects the amount of bacteria in the intestine, so it can reduce symptoms for about 6 months when used within the appropriate doses determined by the doctor, and it can be reused in If symptoms appear again.
Alosetron: Alosetron is used to treat severe chronic irritable bowel syndrome that is accompanied by diarrhea, especially if this diarrhea lasts for at least 6 months in women who suffer from it as one of the main symptoms of suffering from Irritable Bowel Syndrome. Alosetron is given after other treatments have failed, and it is worth noting that alosetron has not been shown to be effective in men with IBS.
Iuxadoline: Oxadoline is an opioid receptor stimulator, which reduces intestinal motility and relieves the associated pain, so it is used to treat irritable bowel syndrome accompanied by diarrhea. It affects brain function.

Medicines that help relieve pain (pain relief socks)

Abdominal pain is one of the distinguishing symptoms of Irritable Bowel Syndrome, and the intensity of irritable bowel syndrome is usually variable; it may range from mild to severe at times. The most important drugs that help relieve this pain are mentioned:

Antidepressants: Antidepressants can help relieve abdominal pain resulting from suffering from Irritable Bowel Syndrome. In fact, there are two types of antidepressants that can be used, and in what follows:

Tricyclic antidepressants: These drugs can help treat depression as they suppress the activity of the nerve cells that control the intestine, which helps relieve pain, and it is worth noting that the doctor will prescribe low doses of these drugs for sufferers who suffer from Symptoms of irritable bowel syndrome only without suffering from depression, examples of these drugs include Imipramine, Desipramineor, and Nortriptyline, and the side effects of these drugs include: blurry vision, dizziness , dry mouth, And drowsiness that can be avoided by taking the medicine at bedtime.

Antidepressants that inhibit serotonin reuptake inhibitor: , short for SSRIs, this group of drugs helps to treat people with depression in addition to Irritable Bowel Syndrome associated with constipation and abdominal pain together, examples of these drugs are Fluoxetine or Paroxetine .

Drugs anti-cramps: adopts the principle of the work of medicines to relieve pain caused by irritable bowel syndrome through energizes smooth muscle in the digestive system, have proven anti - tic moderately effective in relieving pain caused by irritable bowel syndrome, and in fact there are two types of antibiotics Convulsion In what follows a statement for each of them:

Anticholinergics: Anticholinergics are a type of medicine designed to prevent the action of the acetylcholine compound, which leads to a reduction in the severity of muscle spasms, in addition to reducing the excessive production of mucus, and it should be noted that these drugs may cause constipation, so they are usually used For patients with IBS with diarrhea.

Mebeverine: Mebeverine is used to relieve the pain of bloating and cramping in the lower abdomen that is usually associated with irritable bowel syndrome, as mebeverine works to relax certain muscles located in the intestinal wall.

Pain relievers: Some pain relievers, such as Pregabalin and Gabapentin, can be used to treat severe pain and swelling.

Tips and advice to reduce symptoms of IBS

The treatment of irritable bowel syndrome depends on controlling and treating symptoms through dietary changes and lifestyle control. This advice can be explained in some detail as follows:

Diet (f factor diet)

Some people with irritable bowel syndrome have problems when eating a variety of foods. This is due to the body's reaction to these foods, and although some types of foods may cause discomfort in patients, there are many foods that people with irritable bowel syndrome can eat without causing any problems. Some of them are mentioned:

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Eat any type of cooked vegetable, except for cabbage and cauliflower, as it may cause gas for some people.
Gradually increasing your intake of foods high in fiber.
This can help many patients.
Make sure to drink about 1.5-2 liters of water a day.
Avoid dairy products for people with lactose intolerance, and replace them with lactose-free products.
Avoid or limit foods rich in gluten, as this may help reduce the severity of symptoms associated with IBS for some people.
Eat meals on time, and avoid skipping any of them.
Avoid eating too quickly.
Not eating a lot of greasy, spicy or processed foods.
Not drinking more than 3 cups of tea or coffee a day.
Not to drink more soft drinks .
Eat a moderate amount of foods high in the sugar substitute sorbitol, such as dried prunes and prune juice.
Trying some herbal drinks and foods that help relieve the effects of IBS in some sufferers, such as: Peppermint drink, which helps relieve colic and relax the intestinal muscles, in addition to ginger, which relieves nausea and relaxes the stomach, and chamomile, lemon balm, and caraway to help relieve gas And improve digestion, and you can try foods and supplements that contain the beneficial bacteria.