Irritable Bowel Syndrome (Spastic Colon, Mucous Colitis)

Irritable bowel syndrome, or IBS. produces myriad symptoms that affect mostly the large intestine. Abdominal pain and cramping, bouts of diarrhea alternating with constipation, gas, bloating, and nausea are among the complaints that make IBS the third most common intestinal disorder seen by doctors. It is exceeded only by heartburn and indigestion. An estimated 40 million Americans have the syndrome, with women outnumbering men two to one. Often associated with stress, IBS usually appears first in late adolescence or early adulthood.

The disorder affects peristalsis, the intestinal contractions that move digested food and waste through the digestive system. Normally, these contractions are gentle and well coordinated. In a person who has irritable bowel syndrome, however, peristalsis is irregular and poorly coordinated, with contractions alternating between overly forceful and too weak. This irregularity produces the characteristic symptoms.
No anatomical abnormality causes the condition, but emotional factors, diet, drugs, and hormones can precipitate or aggravate it. Some doctors believe that food allergies or sensitivities may also be involved.

Diagnostic Studies and Procedures

One key to an accurate diagnosis is a thorough medical history, including an account of the patient's medications and diet. The doctor will also ask about any personal problems, emotional concerns, and such habits as smoking, drinking, and recreational drug use.

Diagnostic studies are aimed at ruling out any other conditions that could cause similar symptoms. A physical will include a rectal examination, as well as a pelvic examination in women. Using a slender tube with lighting and magnifying devices, a doctor will inspect the inner lining of the rectum and the lower segment of the large intestine in a procedure called proctosigmoidoscopy. Endoscopy, a similar examination of the esophagus, stomach, and duodenum portion of the small intestine, may also be performed. And stool samples will be studied for the presence of blood and parasites.

Other tests may include an ultrasound examination of the abdominal area and barium studies of the upper and lower gastrointestinal tract. The latter tests involve taking X-rays after barium, an opaque substance, is swallowed and also infused into the colon.

Medical Treatments

Once organic disease has been ruled out, the goal of treatment is to alleviate symptoms. Antispasmodic drugs may be prescribed to relieve abdominal cramps. Some patients may be given a short course of tranquilizers to cope with a period of severe stress. Psychotherapy may also be recommended.

Alternative Therapies

A number of alternative approaches can help to control IBS.

Aromatherapy. To promote a sense of well-being, therapists recommend soaking three or four times a week in a bath with rose oil added to the water, to treat diarrhea, they advocate inhaling two drops of rosemary oil and then two drops of black pepper oil. Their remedy for constipation is to inhale two or three drops of marjoram oil.

Herbal Medicine. Cascara sagrada. or buckthorn, may promote normal digestive function, especially during a bout of constipation. It is available in capsules and tablets. Care is needed to avoid an overdose, which can cause diarrhea. Other herbs that are said to promote normal digestion are chamomile and pau d'arco, which can be taken as pills, extracts, or teas.

Hypnotherapy. Some people find this approach beneficial in dealing with the symptoms of irritable bowel syndrome, as well as for stress reduction.

Nutrition Therapy. Diet is crucial in controlling IBS. Nutritionists suggest keeping a diary to identify foods that may trigger symptoms. During a flare-up, a bland diet that eliminates fatty or spicy foods may help. Some naturopathic nutritionists recommend charcoal tablets to alleviate gas. After symptoms subside, a low-fat, high-fiber diet is prescribed. Drinking three glasses of unsweetened black currant juice a day is said to help regulate bowel function. To minimize gas and bloating, such foods as beans, cabbage, and onions should be avoided.

Reflexology. Practitioners use foot massage to treat diarrhea and constipation, as well as cramping and bloating.

Yoga and Meditation. These and other relaxation techniques can help counter the stress that often precipitates IBS.

Self-Treatment

Self-care emphasizes a lifestyle of moderation. Abstain from alcohol and caffeine, or use these substances only occasionally and in small amounts. Exercise regularly, and make sure you get enough sleep. Strive to manage stress. If you find this difficult, try the alternative therapies described above. Or experiment with progressive relaxation exercises, in which you alternately contract and relax muscle groups, starting with the toes and working upward. Whenever stress mounts, take 10 to 15 minutes to go through this routine. During a flare-up, alleviate pain and cramping with a heating pad, hot water bottle, or warm bath.

Other Causes of Irritable Bowel Symptoms

Inflammatory bowel disorders and diverticulosts can produce similar symptoms. Intestinal parasites, particularly giardia, may also be responsible, as may lactose intolerance or various malabsorption syndromes.