IRRITABLE BOWEL SYNDROME (IBS)

IRRITABLE BOWEL SYNDROME (IBS)

Definition of Irritable Bowel Syndrome (IBS)
It is a functional bowel disease and is a chronic disease characterized by vague abdominal pain, abdominal bloating, and changes in defecation frequency and stool consistency. It also has names such as spastic colon, spastic bowel, mucosal colitis and spastic colitis. There is no structural problem in the intestines, the diagnosis is made after clinical findings and the absence of other diseases are determined. While the complaints about the intestines described above are found in many other bowel diseases, abdominal pain that is relieved by defecation is very typical in irritable bowel syndrome.

In Whom Is Irritable Bowel Syndrome More Common?
It is a chronic disease that usually starts after the age of 40. More than 30% of the general population is affected by this disease at some point in their life. It is observed 2-3 times more frequently in women. Psychiatric disorders such as depression and anxiety are twice as common in people with IBS.

Why Does a Person Have Irritable Bowel Syndrome?
It is not possible to fully reveal the causes of IBS. However, studies have found that people with IBS have abnormal bowel movements and impaired conduction between the muscles and nerves in the intestinal wall. As a result, the intestine makes incompatible movements to expel the feces, and the person experiences abdominal pain, bloating, and problems with the consistency and amount of stool. It has also been determined that in some people, the large intestine wall is very sensitive to stretching, and the amount of feces that would not cause discomfort in a normal person causes stretching and severe pain in these people, depending on the sensitivity of the bowel wall. Some people with IBS have been found to have excessive amounts of bacteria in their small intestines through a number of special tests, and it has been observed that they have complaints accordingly. Problems in a person's body resistance cause changes in the bacteria that should normally be present in the large intestine and mild inflammation in the large intestine wall, which can cause IBS symptoms to occur. The relationship between psychiatric disorders and IBS has not been fully established. However, IBS complaints are very common in people with panic disorder, major depression and hypochondriacs (also known as hypochondriacs).


Symptoms in Irritable Bowel Syndrome
The most typical symptom for IBS is “abdominal pain that is relieved by defecation.” Changes in stool consistency and frequency of defecation are very common. There may be defecation in the form of constipation, diarrhea or intermittent attacks of constipation and diarrhea. Additionally, very hard defecation and associated pain may occur. Apart from these, there is an urgent need to go to the toilet, gas pains, a visibly swollen abdomen (it is often stated that the belt has to be loosened), a feeling of insufficient defecation, and inability to fully evacuate the stool. Stress can cause complaints to increase even more. However, the following symptoms are not typical for IBS. In this case, it is recommended to see a doctor urgently.
• In middle-aged and older people
• Increasing severity of symptoms (such as increasing complaints of abdominal bloating…)
• Loss of appetite
• Weight loss
• Fire
• Blood in stool
How is Irritable Bowel Syndrome Diagnosed?
The diagnosis of IBS is made after it is determined that there are no other diseases (tumor, inflammatory bowel disease, etc.) that cause the same complaints in the large intestine. First of all, a detailed history and physical examination must be performed. Tests such as blood tests, occult blood in the stool, complete visualization of the inside of the intestine with flexible sigmoidoscopy or colonoscopy, and imaging methods (such as intestinal films) may be required.

What is the Treatment of Irritable Bowel Syndrome?
IBS is not cancer or a life-threatening disease. It does not cause cancer, bleeding, or inflammatory bowel disease (ulcerative colitis, Crohn's disease). The most important approach to treatment is to avoid stress, which can cause and aggravate IBS. In some people, stress reduction, behavioral therapy, biofeedback, and relaxation exercises help relieve IBS symptoms.
Changes in dietary habits are recommended for those with mild and moderate complaints. Eating foods that are difficult to digest and accelerate intestinal passage in the daily diet may reduce the symptoms. Adding nutrients such as stool softening foods and psyllium seeds to the diet can help reduce abdominal cramps, create soft stools, and prevent diarrhea. Consuming plenty of water can contribute to softening the stool and reducing constipation. Foods such as whole grains, fruits, salads and vegetables (zucchini, broccoli, beans) accelerate intestinal passage. High protein foods and low fat foods like chicken, turkey, fish, lean meat, milk, low fat cheese are very beneficial for health. Fibrous foods (unprocessed fiber foods are very diverse, have high nutritional value and are very cheap), fruits (grapes, oranges, plums…), salads (spinach is the best) and vegetables (broccoli, green beans, etc.) are both healthy and gut-friendly foods. Patients should be advised to consume a diet that produces soft stools. It should be low in sodium and sugar, and have 6 grams of fiber per teaspoon.
In individuals with severe complaints, medication may be necessary. Medicines contribute to controlling the symptoms, but do not cure the existing disease. These directly affect the intestinal muscles and cause contractions to return to normal. It has been observed that the use of low doses of antidepressants relieves individuals with IBS.

What is the Effect of Probiotic Yogurt on Irritable Bowel Syndrome?
Organisms beneficial to human health that are taken orally and settle in the intestines and have a positive effect on increasing the microbial balance are called "probiotics". The most common probiotic bacteria is "lactobacilli" and is abundant in yoghurt. In addition to beneficial bacteria that help digestion and keep the intestines healthy, there are also harmful bacteria in our intestines. Normally, the number of beneficial bacteria is much higher. This balance may be disrupted and the number of harmful bacteria may increase due to antibiotics, long-term use of birth control pills, excessive stress, and diets containing sugar and refined carbohydrates (such as white bread, white rice, white pasta). Probiotic yoghurts can suppress existing inflammation by regulating the resistance of the large intestine, and can alleviate complaints by increasing the number of beneficial bacteria and ensuring balance. For this reason, individuals with IBS may be recommended to eat a bowl of probiotic yoghurt every day.

Which Foods and Habits Should Be Avoided in Irritable Bowel Syndrome?
Very fatty and fried foods should be avoided. Coffee and alcohol can cause cramps and diarrhea. Sorbitol, often found in sweeteners, and fructose, found in natural honey and some fruits, may not be absorbed well from the intestines and may cause cramps and diarrhea. If your doctor deems it necessary, he may advise you to cut down on caffeine, coffee, tea, chocolate, and cola-alcoholic beverages. Likewise, smoking has an aggravating effect on IBS symptoms.

How Long Should Treatment Be Continued for Irritable Bowel Syndrome?
IBS symptoms may take a long time to resolve despite treatment. There is a significant reduction in symptoms over six months or longer. It is very important for the patient to be patient and not expect immediate recovery in solving the problem. Stress will always have an impact on the gut. IBS symptoms are greatly reduced with a good diet, increasing stool-softening foods, and using bowel movement-enhancing medications.