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Irritable Bowel Syndrome - IBS Medical Malpractice
Irritable bowel syndrome is a medical condition in which there is bloating, constipation and/or diarrhoea, abdominal pain and irregular stools. It is a painful condition that fortunately doesn't harm the intestines themselves. For this reason, it is a diagnosis of exclusion when the doctor has determined that no real inflammatory condition exists. It can be a debilitating disease, with the inability to work, travel or attend personal events. About twenty percent of adults have symptoms of irritable bowel syndrome so that it is commonly diagnosed. More women get the condition than men and it usually occurs in adults under the age of 35 at first onset.
The main symptoms of irritable bowel syndrome include discomfort in the abdomen which can lead to pain, bloating and constipation, diarrhoea or alternating constipation and diarrhoea. Pain can be there with or without the urge to pass stool. There may be mucus in the stool from the colon. Symptoms tend to come and go or can worsen over time.
No one knows what causes irritable bowel syndrome. The colon seems to be extra sensitive to stress as well as to certain foods. The immune system may be involved but the exact way it is involved is not clear. There tends to be abnormal motility of the colon that makes it spasmodic or makes it unable to work at all. There can be strong smooth muscle contractions that come and go over time. The lining of the colon can lose the ability to absorb fluids so that there is too much water in the colon. The contents of the bowels move too quickly and diarrhoea results. In other people, the colon moves too slowly and too much water is absorbed, leading to constipation. Foods or stress can contribute to these phenomena.
Some research has linked the neurotransmitter serotonin to colon problems. The vast majority of serotonin is located within the GI tract, with the rest found in the brain. People with IBS have a reduced ability to transport serotonin causing abnormal amounts of serotonin within the colon. Bacteria may trigger IBS as well. There are normal and healthy bacteria within the colon that contribute to normal stools and those with IBS might have abnormal numbers and kinds of bacteria in the colon. There also may be more pain receptors within the colon. You can get a bout of IBS after having a gastroenteritis infection but this tends to be temporary. It's possible that some people with IBS have mild celiac disease so that they don't tolerate glutens in wheat, rye and barley. There is fortunately a blood test that can diagnose celiac disease.
IBS diagnosis is a diagnosis of exclusion. This means the doctor must do a complete history and physical exam, followed by blood tests for celiac disease and possibly a biopsy of the colon to rule out Crohn's disease or inflammatory bowel disease. Stool samples can be done to see if there is infection in the colon and x-rays can show if there is some other disease going on. A colonoscopy or flexible sigmoidoscopy might be indicated in order to take a biopsy or look at the colon.
Things that trigger worsened IBS symptoms include large meals, medications, gas in the colon, wheat, milk, alcohol, barley, chocolate or rye, caffeine, stress, emotional upsets or conflict. It tends to be worse during a woman's menstrual period as well. Related conditions to IBS are depressive symptoms and anxiety symptoms but it is unsure whether or not the IBS symptoms come first.
There are treatments for IBS although up to seventy percent of all people with IBS are not seeking treatment because they don't recognize there is hope for treatment. There is, however, no cure found for irritable bowel syndrome and the treatment is symptomatic. Fibre laxatives are recommended or other kinds of laxatives in those who have constipations. Anti-diarrhoeal medications are recommended for those who have diarrhoea. Antidepressants seem to help some people as do antispasmodics. Some antispasmodics contain a mild sedative which relaxes you but can be habit forming so the doctor needs to be careful not to prescribe too much.
A newer medication is called Lotronex, which has been approved for women with severe IBS that doesn't respond to regular therapy. There can be serious side effects so it is used as a last resort in many cases.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here