Irritable bowel syndrome (IBS) is a common functional disorder affecting the gastrointestinal system, especially the colon. It is characterized by various disturbances, including disruptions in bowel habits and abdominal pains without any definite pathological cause. This disease significantly affects individuals of all ages as it interferes with their quality of life (Weaver et al., 2017). It also possesses a considerable economic burden to people due to its chronic nature. Moreover, IBS impairs the work productivity and the social interactions of individuals in cases where it co-exists with other psychological conditions such as anxiety disorders. Therefore, appropriate diagnosis and treatment are crucial for the management of the undesirable sequel of this condition. This paper provides an in-depth literature review of three articles touching on the diagnosis and treatment of IBS.
Diagnosis of IBS
The three articles have talked about the strategies for the diagnosis of IBS. The first article touches on the symptomatic diagnosis of the disease. The signs of interest in this diagnostic criteria are abdominal discomfort or pain, which began more than six months ago with at least three days of discomfort per month in the past three months. Furthermore, the abdominal distress tends to be relieved with defecation, and it begins with changes in the form and the frequency of stools in the patient. According to this literature, the Rome Criteria of diagnosing IBS classifies patients due to their stool pattern, constipation, and diarrhea.
Patients are put into groups including IBS-C, IBS-D, IBS-M, and IBS-U according to the days of abnormal bowel movements (Weaver et al., 2017). It also incorporates history taking of patient’s information on dietary patterns, anorectal physical examination, and laboratory tests of the complete blood count or c reactive protein tests. A careful analysis of the character of the presenting symptoms coupled with a focused history is key for the diagnosis of IBS.
The second article analyzed also has touched on the Rome criteria for diagnosing IBS. It outlines the changes in this framework, which led to changing the symptom focus from abdominal discomfort or pain to purely abdominal pain (Ferreira et al., 2020). Additionally, this criterion shows that the abdominal pain indicative of IBS is specifically localized in the lower quadrant. Abnormal bowel movements are explained as three or more bowel movements per day or less than three bowel movements in a week (Ferreira et al., 2020). Besides, physical examination is important to rule out the organic causes of IBS and other conditions, including rectal cancers and perianal fistulas.
Additional findings portray cases of IBS co-existing with other abdominal conditions. A significant number of patients with active Inflammatory Bowel Disease (IBD) were found to have symptoms of IBS. In this case, the measurement of the fecal calciprotein levels is key in guiding treatment modalities (Dunn et al., 2019). Moreover, an overlap of symptoms of the IBS is shown to co-exist with microscopic colitis. Several scholars have invented the use of biomarkers to distinguish between IBS and other conditions. These biomarkers include antibodies, autoantibodies, fecal bile acids, and nerve growth factors for the effective diagnosis of IBS (Weaver et al., 2017).
However, little effectiveness of these biomarkers has been established by scientists in the diagnosis of this disease. Further studies are needed to determine their effectiveness as the gold standard diagnostic option for this chronic abdominal illness.
Treatment of IBS
The treatment of the IBS is diverse, incorporating the use of pharmacological and non-pharmacological options. Pharmacological options are aimed at the symptomatic management of abdominal pains, diarrhea, or constipation. The drug therapies available for treating IBS include peppermint oil, antispasmodics, tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRIs) (Weaver et al., 2017). The IBS-D subtype, which comprises abdominal pains with significant instances of diarrhea requires treatment with other drugs, including opioid agonists, bile salt sequestrants, and antibiotics.
The IBS treatment is guided by recommendations by the American Gastroenterological Association (AGA), which classified these drugs according to their efficacy in treating this condition. Studies found strong evidence in using linaclotide for individuals diagnosed with IBS-C (Ferreira et al., 2020). A study by Gunn et al (2019), to determine the effectiveness of ondansetron in treating IBS found that it is also important in reducing the urgency and frequency of diarrhea and bloating in patients.
Furthermore, non-pharmacological options are effective in treating IBS. The use of dietary adjustments, mind-body therapies, and exercise are beneficial treatment alternatives. Improvements in the symptoms of the IBS were observed in individuals who refrained from dietary sources rich in gluten, including dairy products and wheat. Additional low intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (or FODMAPs) foods with guidance from a nutritionist are also effective in treating the symptoms IBS. Another study found the effectiveness of engaging in physical activities in lowering the symptoms of this illness (Ferreira et al., 2020). Patients with IBS who participated in this intervention had proportionately improved quality of life and psychological wellbeing compared to non-participants.
Irritable bowel syndrome is a chronic disease affecting individuals despite differences in age, sex, or race. A comprehensive history taking, physical examinations, and laboratory tests are crucial for diagnosing the condition. The Rome IV guidelines aid the clinician in effective identification of the condition. Furthermore, the adequate incorporation of pharmacological and non-pharmacological options is key for treating the IBS. Further research is needed to identify the effectiveness of using biomarkers in diagnosing IBS. Furthermore, stronger studies are crucial to determine the effectiveness of other management modalities, including psychological support.
Ferreira, A. I., Garrido, M., & Castro-Poças, F. (2020). Irritable bowel syndrome: News from an old disorder. GE-Portuguese Journal of Gastroenterology, 27(4), 255-268. Web.
Gunn, D., Fried, R., Lalani, R., Farrin, A., Holloway, I., Morris, T., Olivier, C., Kearns, R., Corsetti, M., Scott, M., Farmer, A., Emmanuel, A., Whorwell, P., Yiannakou, Y., Sanders, D., Mclaughlin, J., Kapur, K., Eugenicos, M., Akbar, A., Trudgill, N., Spiller, R. (2019). Treatment of irritable bowel syndrome with diarrhoea using titrated ondansetron (TRITON): Study protocol for a randomised controlled trial. Trials, 20(1), 517. Web.
Weaver, K. R., Melkus, G. D., & Henderson, W. A. (2017). Irritable bowel syndrome. The American Journal of Nursing, 117(6), 48–55. Web.