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Irritable Bowel Syndrome (IBS) is a common disorder affecting the large intestine. The main types of IBS are classified based on the predominant stool pattern:
Types of IBS
- IBS with Constipation (IBS-C):
- Predominantly hard or lumpy stools at least 25% of the time and loose or watery stools less than 25% of the time.
- IBS with Diarrhea (IBS-D):
- Predominantly loose or watery stools at least 25% of the time and hard or lumpy stools less than 25% of the time.
- Mixed IBS (IBS-M):
- Both hard or lumpy and loose or watery stools more than 25% of the time.
- Unsubtyped IBS (IBS-U):
- Symptoms do not fit the other three categories. Stools may vary widely without a predominant pattern.
Diagnosis
IBS is diagnosed primarily based on symptoms and by ruling out other conditions. The Rome IV criteria are commonly used for diagnosis:
- Rome IV Criteria: Recurrent abdominal pain on average at least 1 day per week in the last 3 months, associated with two or more of the following:
- Related to defecation.
- Associated with a change in the frequency of stool.
- Associated with a change in the form (appearance) of stool.
To exclude other conditions, doctors may conduct tests such as:
- Blood Tests: To check for infections, inflammation, or celiac disease.
- Stool Tests: To look for infections or malabsorption.
- Colonoscopy or Sigmoidoscopy: To view the inside of the colon and rectum.
- Imaging Tests: Such as CT scans or abdominal X-rays.
Treatment
Treatment for IBS focuses on relieving symptoms and may include:
- Dietary Changes:
- Low FODMAP Diet: Reducing foods that are high in fermentable oligo-, di-, mono-saccharides, and polyols.
- High-Fiber Diet: Particularly for IBS-C, to help with constipation.
- Avoiding Trigger Foods: Such as gluten, dairy, caffeine, and fatty foods.
- Medications:
- Fiber Supplements: For IBS-C.
- Laxatives: For IBS-C.
- Anti-diarrheal Medications: Such as loperamide for IBS-D.
- Antispasmodics: To reduce abdominal pain and cramping.
- Antidepressants: Low doses of tricyclic antidepressants or SSRIs may help relieve pain and other symptoms.
- Newer Medications: Such as rifaximin (an antibiotic), eluxadoline (for IBS-D), or linaclotide and lubiprostone (for IBS-C).
- Lifestyle Changes:
- Regular Exercise: To help with overall bowel function.
- Stress Management: Techniques such as mindfulness, meditation, or cognitive behavioral therapy (CBT).
- Probiotics:
- Some people find relief from IBS symptoms with probiotics, though the effectiveness can vary.
- Psychological Therapies:
- CBT, hypnotherapy, or other forms of psychological therapy can be beneficial for some individuals with IBS.
Treatment plans are often individualized, as IBS symptoms and their severity can vary greatly from person to person. Regular follow-ups with a healthcare provider are essential to manage and adjust treatments as needed.
