Irritable Bowel Syndrome
Irritable Bowel Syndrome (IBS) is the most common condition diagnosed by gastroenterologists yet general lack of understanding of the severity of the condition and the resulting inability to function properly is not fully understood by others. It is often misdiagnosed, treatments are few and no cure exists. The gastrointestinal condition is characterised by a combination of symptoms similar to those of ulcerative colitis and Crohn’s disease, though these conditions are of greater severity.
The precise cause(s) of IBS remains theoretical but stress is known to be at least a contributor to the condition. IBS can best be described as the loss of muscular control, to varying degrees, during peristalsis which is the coordinated muscular contractions that occurs while food moves through the intestines. When this action is functioning as it should it goes unnoticed. Of the people afflicted with IBS, about half trace the beginnings of their illness to a major change in their lives such as a death in the family or loss of job. This indicates that “there may be a psychological trigger in susceptible patients” (Rutherford, 2006). IBS is increasingly becoming better understood as a chronic and widespread condition which deserves further study to determine more effective health care strategies.
The pain and discomfort of IBS usually lasts for more than 12 weeks per occurrence during which the individual experiences episodes of chronic discomfort occurring more than once per week. In a survey which involved more than three hundred people that complained of various intestinal discomforts, half were diagnosed with IBS. Of those, two-thirds had suffered with IBS for at least five years before seeking treatment. The principle symptoms of those afflicted with IBS include abdominal pain, diarrhea, and chronic constipation in addition to other types of discomfort. An alternating pattern of diarrhea and constipation is a frequent complaint along with the inability to evacuate their bowels completely while having a movement. Patients generally experience pain and/or spasms of the abdomen and feel bloated. The severity of this discomfort is relieved significantly following the passing of wind or having a bowel movement (Rutherford, 2006).
The onset of symptoms is also associated with a change in number of incidences of bowel movements and/or the appearance (form) of the stool. Irregular bowel movement frequencies is usually defined as having more than three per day or less than three per week. It is, however, very important to realise that there exists many variations of IBS and individuals may endure some but not every symptom. In the instance where pain is the main symptom and the patient experiences little or no relief from bowel movements, the afflicted person is diagnosed with another of the gastrointestinal disorders (Reid, 2002). A popular myth surrounding IBS is that this disorder increases the likelihood of intestinal diseases including cancer. This has been shown to be untrue. “IBS has not been shown to lead to any serious, organic diseases, including cancer” (Roseman, 2006). Individuals suffering from IBS do not have a greater probability to contract other diseases than do people with no intestinal issues. Patients with IBS, contrary to what they have been led to believe by some in the past, do not need to feel compelled to have more frequent examinations than they normally would.
IBS affects persons of all socioeconomic spheres, cultures and societies throughout the world. The condition is considered chronic for the majority of patients suffering from the disorder which leads to severe life consequences. “There is strong evidence that persons with IBS reveal impaired health-related quality of life” (Dean et al, 2005: S18). The quality of an IBS patient’s life is seriously compromised by the effects of the disorder but the addressing of their individual needs has not been of paramount importance in either the health care or business arena. What can be crippling pain often alters physical as well as cognitive functions on a regular basis whether at home or on the job. IBS causes people to be absent from work at a higher rate than their colleagues and in addition disrupt their ability to function well in all social situations. It is difficult for an IBS patient to hold a regular job or otherwise effectively care for themselves or their family at all times which generates stress which then causes additional pain. This seemingly never-ending and ever-escalating cycle is a common complaint amongst IBS patients. Studies involving IBS patients have revealed a number of problems they face in addition to the normal, everyday issues faced by all persons.
Psychological aspects of IBS
Because specific causes or cures of IBS cannot be identified, patients justifiably worry that others, including members of their family and health care providers, do not believe them when they claim to be ill and tend to disregard their genuine need for medical treatment. This lack of empathy originates from the ‘negative’ results of initial diagnostic examinations. These tests fail to find an apparent structural causation to explain the individual’s symptoms. When a patient is informed that their exhaustive testing, which includes the very uncomfortable colon exam, has come back negative, they often perceive that the doctor is telling them that there is nothing wrong with them. This is a very disheartening revelation. Many times, doctors do not take this into account and thus fully explain the reasons why the findings might not have produced the expected results. Furthermore, doctors seldom fully communicate the nature of the chronic symptoms – for example, that the symptoms are cyclical in terms of occurrence and strength. Since IBS does not follow the same pattern as other chronic illnesses, doctors may not believe they have the ability to assist their patients in developing a realistic expectation regarding a possible recovery. Therefore, the doctor is reluctant to broach the subject.
IBS is not generally thought of as a ‘serious’ condition such as is cancer or Crohn’s Disease. However, the pain associated with IBS is often exceptionally acute and, as a consequence, can be considered a disabling disorder. “Although this disease is not life threatening, patients with IBS seem to be seriously affected in their everyday life” (Pace, 2003: 1037). Following the occurrence of an acutely painful attack, a patient begins to worry about the effects of future episodes so they consequently limit their social activities which not only does nothing to improve their symptoms, this lack of personal interaction tends to increase stress levels thus exacerbating the severity of the condition.
As the condition continues, patients can become increasingly worried that their assertions of the chronic symptoms are being perceived as a manipulative tactic by their family, co-workers and doctor. Patients are often under the perception that others think they are falsifying an illness in order to be catered to or to excuse themselves from assorted responsibilities. Sometimes they are accused outright of such deceptions. IBS patients can also perceive that their symptoms represent a personal shortcoming of some type. Sorting out the method by which to manage the physical symptoms in concert with the psychological and interpersonal issues involved with IBS is not currently a part of the healing process practiced by medical professionals. In some instances, doctors may admit their lack of knowledge pertaining to the treatment of IBS thus patients may believe that they are on their own without hope of relief. The likelihood is that doctors are revealing the limits of medical knowledge in general regarding this disorder instead of exhibiting reluctance on their part to care for the patient because they consider them unworthy of treatment. Only recently has there been information available for either doctors or patients which address alternative treatments. Additionally, studies that discern the connections between IBS symptoms and stressful life situations are in their infancy therefore neither doctor nor patient knows how to effectively approach the disorder in a comprehensive, constructive way. Because of the limitations doctors face in their inability to administer effective treatments, the patients’ concerns regarding their disorder often go unspoken which increases their anxiety and stress.
Deficiencies, associated with IBS
There are several deficiencies that can be associated with IBS. A deficiency of Zinc [a naturally occurring mineral of the body] can be caused by IBS and other intestinal disorders which act to impede the absorption of several nutrients obtained by food. “Zinc supplementation seems to help enhance weight gain and regulate normal appetite signals” (Humphries et al, 1989: 458). Supplementing the diet of an IBS patient with Zinc is particularly important in an overall treatment program because of the weight loss associated with the condition. Preparations containing artichoke extract or peppermint oil have also been demonstrated to be very effectual in the treatment of IBS symptoms (Murray, 2006). In addition, fiber supplements have been steadily growing in popularity as a beneficial treatment for those suffering from IBS.
IBS is much like the common cold in that, though common, is incurable. IBS, however, is a much more painful and long-lasting ailment. Unlike IBS, colds are widely accepted as legitimate ailments and treatments are abundant. Those afflicted with IBS suffer excruciating, long-standing bouts with abdominal pain but often suffer alone and with few options for relief.
Dean, B.B.; Aguilar, D.; Barghout, V.; Kahler, K.H.; Frech, F.; Groves, D. & Ofman, J.J. “Impairment in work productivity and health-related quality of life in patients with IBS.” American Journal of Management Care. Vol. 11. (2005). pp. S17–26
Humphries, L.; Vivian, B.; Stuart, M. & McClain, C.J. “Zinc deficiency and eating disorders.” Journal of Clinical Psychiatry. Vol. 50, N. 12. (1989). pp. 456-459.
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Pace, F.; Molteni, P.; Bollani, S.; Sarzi-Puttini, P.; Stockbrugger, R.; Porro, G.B. & Drossman, D.A. “Inflammatory bowel disease versus irritable bowel syndrome: a hospital-based, case-control study of disease impact on quality of life.” Scandinavian Journal of Gastroenterology. Vol. 38. (2003). pp. 1031–1038.
Reid, Mary. “IBS in the Real World.” International Foundation for Functional Gastrointestinal Disorders (IFFGD). (2002). Web.
Roseman, Bruce. “Irritable Bowel Syndrome.” International Foundation for Functional Gastrointestinal Disorders. (2004). Web.
Rutherford, Dan. “Irritable Bowel Syndrome.” NetDoctor. (2006). Web.