This month rings in Irritable Bowel Syndrome (IBS) Awareness Month. Don’t let the pun get you down, as there is much to discuss about the steps to prevent suffering and to empower our patients to avoid the pitfalls associated with this disease. The optimal quality of life for our patients will always be a driving force of our patient-centered care here at Desert Mobile Medical.
1) IBS is common and its prevalence is estimated at 10-20% of the adult population. Yet, only 5-7% of adults have been diagnosed with the disease. Many do not recognize that IBS may be causing their symptoms. IBS remains one of the most common disorders that a primary care physician oversees.
2) IBS is a major women’s health issue; with 60-65% of individuals who report IBS in the community being women.
3) The 2 hallmark symptoms associated with IBS are abdominal pain and altered bowel habits. These may be accompanied by abdominal bloating or distention, mucus in the stool, heartburn, nausea and vomiting, urgency and possibly incomplete evacuation.
4) You don’t need expensive testing to be diagnosed as long as you are having typical symptoms. As of May 2016, doctors use the Rome IV criteria to diagnose IBS.
5) Four different bowel patterns are making up the four different subtypes:
- IBS-D – Diarrhea predominant
- IBS-C – Constipation predominant
- IBS-M – Mixed diarrhea and constipation
- IBS-U – Unclassified
6) Dietary measures may help some but not all:
- Remember that fiber is your friend. Fiber supplementation in polycarbophil compounds like Citrucel or Fibercon offer better results than psyllium compounds like Metamucil.
- Plentiful water intake is recommended in patients with IBS-C characteristics.
- Caffeine & legume avoidance may benefit others.
- Following a diet devoid of gluten, fructose, and FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), can assist in lowering symptoms in some. Low FODMAP diets can be helpful in this situation, although they may be found to be very restrictive.
7) Psychological treatments/therapy consisting of cognitive-behavioral therapy, dynamic psychotherapy, and/or pharmacological treatments faired the best in this category.
8) Pharmacological treatments are aimed at decreasing the symptoms felt by the patient and consists of:
- Anticholinergics like dicyclomine hydrochloride (Bentyl) and hyoscyamine sulfate (Levsin).
- Antidiarrheals like loperamide (Imodium) and diphenoxylate hydrochloride (Lomotil).
- Antidepressants like amitriptyline (Elavil) and duloxetine (Cymbalta).
- Prokinetic agents like metoclopramine (Reglan).
- Antibiotics like rifaximin (Xifaxan).
- Probiotics.
- Newer agents like Lubiprostone (Amitiza), Linaclotide (Linzess), alosetron (Lotronex),
plecanatide (Trulance), and eluxadoline (Viberzi).
9) If you are experiencing these symptoms and have not seen a physician yet, you might be one of those who have gone undiagnosed or might be having another functional gastrointestinal disorder altogether, Therefore it’s imperative to see a doctor get down to the bottom of this. An accurate diagnosis helps ensure the right treatment.
10) Developing a strong bond with your doctor helps you navigate uncertain waters when it comes to your healthcare including IBS.
