Irritable bowel syndrome - symptoms and treatment. Irritable bowel: symptoms, treatment, diet IBS-like syndrome

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder affecting millions of people. It affects about one-fifth of the world's adult population, with women twice as likely as men.

What is irritable bowel syndrome and what it is not

Irritable bowel syndrome is accompanied by symptoms such as cramps and pain in the abdomen, flatulence, diarrhea, and constipation. Symptoms can come and go, change, and last a lifetime. Sometimes the pain and discomfort can be so severe that people simply cannot go about their daily activities. IBS is often confused with inflammation and other bowel conditions that can cause similar symptoms.

Irritable bowel syndrome is a functional disorder of the motor and secretory function of the intestine, not associated with organic damage. This means that the structure of the intestine is intact, but the nerves and muscles that control the process of digestion are not working properly. The muscles in the colon usually contract and relax in a gentle rhythm that moves food into the rectum. With IBS, intestinal muscles spasm, their contraction becomes stronger and longer than usual. These spasms are painful and interfere with the movement of food through the intestines. If they slow it down, constipation occurs; if they speed it up, diarrhea occurs. Symptoms must be chronic, occurring at least once a week for 3 months.

Suspects of irritable bowel syndrome

Despite the high prevalence of irritable bowel syndrome, it is still poorly understood. Recent studies indicate that the causes of the syndrome may be:

infection and inflammation. Past infection or inflammation of the intestine can adversely affect its function. Even when the inflammation is in remission, but the intestinal nerves have not been able to return to normal, this leads to the appearance of IBS;
microbiome anomaly. This is due to the interaction between gut neurons and the microbiome, the bacteria that live in the digestive tract. Gut motility regulation is one of the functions of the microbiome, and an imbalance of bacteria can affect how the colon functions.
psychosomatic disorder. It has long been assumed that IBS is a psychosomatic disorder caused primarily by chronic stress. Stress hormones provoke atypical contraction of the muscles of the intestine, and prolonged uncontrolled stress can lead to a breakdown in the nervous regulation of the colon.

Can irritable bowel syndrome be cured?

To date, there is no medical treatment for irritable bowel syndrome. Therapy mainly focuses on relieving symptoms such as constipation or diarrhea, as well as relieving abdominal pain with antispasmodics, laxatives, painkillers, and antidepressants. The problem is that such treatment does not address the causes of the syndrome and may have side effects, including toxicity to other organs such as the kidneys, liver, pancreas, eyes, etc. Avoiding certain foods will also not cure IBS, although it does help relieve symptoms.

The most effective are alternative methods for the treatment of irritable bowel syndrome, as well as which requires time and periodic repetition of courses.

Biological medicine against irritable bowel syndrome

Switzerland is the only country in the world that has enshrined access to alternative medicine in its constitution as a basic human right. Biological medicine can help cure irritable bowel syndrome, which relies heavily on the human body's ability to self-regulate and heal itself. The Paracelsus Clinic is the leading center for biological medicine in Europe.

The founder of biological medicine, Dr. Rau, on the right in the photo

To treat irritable bowel syndrome, Paracelsus first determines the underlying cause of the disorder and only then prescribes a treatment plan. Typically, an irritable bowel syndrome treatment program consists of detoxifying the gut, normalizing the microbiome, and resetting the gut. Here it is one of the most successfully cured diseases.

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Spa treatment of irritable bowel syndrome in Italy

Between Florence and the coast of Versilia, in the heart of Tuscany, a few kilometers from Pisa, Lucca, Volterra and the beaches of Viareggio, the thermal spa Terme Montecatini has been treating diseases of the gastrointestinal tract for 700 years. Today, water from the sources of Leopoldina, Regina, Tettuccio and Rinfresco is also used to treat irritable bowel syndrome, accompanied by constipation.

Hydroponic treatment at Terme Montecatini, Italy

To cure irritable bowel syndrome, hydroponic treatment (drinking mineral water) is applied here. Getting inside the gastrointestinal tract, water normalizes the secretions and intestinal peristalsis. Calm rest, regular daily rhythm, therapeutic nutrition, bathing in thermal baths and exercises in the water will help to achieve a positive overall result.

Spa treatment is consistent with modern ideas about the need for complex therapy to eliminate gastroenterological and psychological disorders in irritable bowel syndrome.

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Ayurvedic treatment of irritable bowel syndrome in the Himalayas

AyurVAID Kalmatia is an Ayurvedic resort located in the Indian Himalayas that offers the opportunity to treat in privacy and comfort amid unspoiled nature with breathtaking views of snow-capped mountain ranges. AyurVAID Hospitals is a network of next generation Ayurvedic hospitals, where Ayurvedic methods are applied to solve modern health problems, including irritable bowel syndrome, which in Ayurveda is called Grahani.

Ayurvedic resort AyurVAID Kalmatia, Himalayas, India

According to Ayurveda, Grahani is caused by an imbalance of the three doshas of the body: vata (air), pitta (bile) and kapha (mucus), therefore, in order to cure irritable bowel syndrome, this imbalance must be corrected. Special yoga postures and breathing exercises are an important part of the treatment as they stimulate normal bowel movements. Daily meditation allows you to learn how to manage stress, and Ayurvedic lifestyle recommendations will help prevent recurrences of IBS after basic treatment.

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Drugs for irritable bowel syndrome are indicated to eliminate the unpleasant clinical manifestations of the disease, which cause great discomfort to patients and force them to seek help from gastroenterologists. For this reason, drug therapy is symptomatic and functional. This means that medicinal substances not only improve the condition of a person, but also normalize the work of the affected organ.

It is worth noting that drug treatment will be individual in nature, since each case of the course of such a disease is unlike the other. In some patients, the clinical picture will be dominated by a violation of the stool, in the form of constipation or diarrhea, as well as their alternation; in others, the main symptom may be flatulence and increased gas formation, and in others, an intense pain syndrome. It follows from this that only the clinician can prescribe drugs, based on the etiological factor of the symptom in each patient.

Often the main condition in the treatment of IBS is the normalization of lifestyle and diet. Only in the absence of the effectiveness of such methods, patients need to start taking medications.

Depending on the course of the disease, patients may be prescribed several medications, which are divided into the following groups:

anticholinergic;
antidiarrheal;
antidepressants;
laxatives;
guanylate cyclase agonists;
serotonin receptor antagonists;
prebiotics and probiotics;
antibiotics.

The doctor can determine which medicine should be taken by a particular patient after laboratory tests of blood and feces.

Anticholinergics

Drugs for irritable bowel syndrome from this group have a pronounced analgesic effect, which is why they are indicated to suppress spasms of the smooth muscles of the intestine. Such drugs enable a person to completely get rid of the severe pain syndrome that often accompanies the course of such a disorder.

One of the most effective drugs is considered to be "Bentyl" - this is a medicinal substance that directly affects the smooth muscles of the affected organ and does not affect the secretion of gastric juice. The therapeutic effect is observed within a few hours after taking the tablets, and lasts about four hours. Take this medication four times a day - before each meal and at night.

Nevertheless, it is worth considering that the drug has a large number of side effects. In order to avoid their appearance, the doctor first prescribes a small dose of this remedy, after which he gradually increases the daily rate. It is not recommended to take such a substance for a long time, because with a sharp cessation of administration, a withdrawal syndrome may occur, which will be manifested by increased sweating, dizziness and vomiting.

Undesirable effects from the use of the drug are:

visual impairment;
drowsiness or insomnia;
dizziness;
bloating;
heart rhythm disturbances;
confusion;
hallucinations.

In addition, there are several undesirable situations in the use of such a drug. The main contraindications include:

the period of breastfeeding the baby;
the age of the patient is up to six months;
GERD;
severe course of ulcerative colitis;
intestinal obstruction;
kidney, heart or liver failure.

Another drug from the group of acetylcholine blockers is Hyoscyamine. The medicine leads to a slowdown in the peristalsis of the irritated bowel.

It is necessary to take such a medication strictly according to the prescription of the attending physician. In cases of overdose, the following symptoms are expressed:

violation of urination;
blurred vision;
increase in intraocular pressure;
drowsiness and nervousness;
nausea that ends in vomiting;
violation of the chair;
allergic skin rashes.

Such a drug has almost the same contraindications as the previous remedy, but diaphragmatic hernia, coronary heart disease, Down syndrome and obstructive pulmonary disease can also be added to them.

In addition to the above medicines, the following medicines with an analgesic effect can be prescribed for the treatment of such an ailment:

"Papaverine";
"No-shpa";
"Enterospazmil";
"Duspatalin".

Antidiarrheal medicines

Quite often, such an ailment is manifested by such an unpleasant symptom as profuse diarrhea. Antidiarrheal drugs for the treatment of irritable bowel syndrome slow down the passage of food and reduce the production of digestive juices.

Often, patients with a similar diagnosis are shown taking Lomotil. This is a combined medication that reduces the frequency of the urge to defecate with diarrhea, which occurs against the background of a slowdown in intestinal motility. Patients note that a decrease in the manifestation of such a symptom occurs after two days of taking the medication. The daily rate of tablets for adults is two pieces four times a day, for children under thirteen years of age, the medicine is prescribed in the form of syrup, and the dosage is calculated depending on the weight of the patient. As the diarrhea subsides, the dosage of the medicine is reduced.

The side effects of this substance are:

feeling of dryness in the mouth;
nausea and vomiting;
abdominal discomfort;
violation of the heart rhythm;
an increase in the volume of the abdomen;
loss of appetite;
dyspnea;
violation of the chair in the form of constipation.

"Lomotil" is strictly prohibited for people with individual intolerance to the active substances of such a drug, obstructive jaundice, ulcerative colitis, impaired functioning of the kidneys and liver.

Another cure for irritable bowel syndrome is Loperamide. It slows down the peristalsis of the affected organ and reduces the water content of the feces, thereby stopping diarrhea. Adult patients should take two tablets after each bowel movement, provided that the feces look like diarrhea. Do not drink more than eight tablets per day. The daily rate for children is assigned individually. The medicine is contraindicated in children under two years of age, as well as at high body temperature. In cases of overdose, there is a possibility of:

bloating;
aversion to food;
nausea and dizziness;
skin rashes;
drowsiness;
stomach ache;
dry mouth.

In addition, the following drugs may be prescribed for diarrhea:

"Imodium";
"Enterol";
"Loperamide";
"Salofalk";
"Alpha Normix";
"Hilak-Forte";
Lactofiltrum.

Antidepressants

Irritable bowel syndrome in its clinical picture quite often has such a symptom as a depressive state, which is formed against the background of other clinical signs. In cases of such a manifestation, the attending physician may prescribe "Amitriptyline", which, in addition to the main effect, relieves pain and improves the patient's well-being. The daily norm is 50 milligrams. It is best to take the medicine before bed.

The medication is contraindicated for allergic reactions to the main component, myocardial infarction and the patient's age up to twelve years. Overdose is very rare, but can cause:

nausea and vomiting;
frequent urge to urinate;
swelling of the mammary glands;
dizziness;
weaknesses;
increase in body temperature.

The group of antidepressants should also include:

"Imipramine";
"Fluoxetine";
"Citalopram".

All drugs from this group should be taken only under the strict supervision of the attending physician.

Other medicines

Very often, clinicians prescribe antibiotics to their patients. For the treatment of IBS, the use of potent drugs is indicated. Such drugs will help reduce the number of pathological organisms in the digestive tract.

Taking such medications is due to the fact that with any course of such a disease, there is a symptom such as an increase in size or bloating. This indicates that the main cause of the onset of the disease is an increase in the number of pathogens, against which intestinal irritation occurs.

It is necessary to take them only as prescribed by the attending physician and not more than two weeks.

Often, laxatives are used as drug therapy, which increase the volume of feces. When ingested, such drugs form a gel aimed at stimulating the peristalsis of the affected organ and facilitating the passage of intestinal contents. Against this background, there is a decrease in the intensity of the manifestation of constipation.

Serotonin receptor antagonists - are used only in cases where IBS manifests itself in severe diarrhea and does not respond to standard treatment. The daily allowance for adults is 0.5 milligrams. The course of therapy with such drugs usually lasts no more than four weeks. In cases of overdose, the following may occur:

constipation;
hemorrhoids;
flatulence;
nausea;
soreness in the bones;
ischemic colitis.

Guanylate cyclase agonists - increase the secretion of fluid into the intestinal lumen and accelerate the passage of contents. In addition, drugs in this group reduce the manifestation of soreness and discomfort in the abdomen.

Prebiotics and probiotics. The former provide a breeding ground for the growth of beneficial bacteria. The second group of drugs contains live microorganisms that are needed to normalize the digestive processes.

These include:

"Bifiform";
"Laktofiltrum";
"Enterogermina";
"Bactistatin";
"Lacidophilus" and others.

In addition to the main therapy, they also prescribe:

"Espumizan";
"Afobazol";
"Adaptol";
"Linaclotide";
"Lubiproston";
"Alosetron";
"Trimedat";
Creon.

Due to the wide variety of drugs prescribed for irritable bowel syndrome, only the attending physician determines how to treat the disease. The clinician is based on several factors, namely the severity of the course of the disease, which of the symptoms prevails, the age and weight of the patient.

Few of us can answer the question of what role the intestines play in our body. And it is quite significant in maintaining good human health. A lot depends on how well it works. Its main purpose is to work the digestive system as a whole.

It is difficult to argue with the statement that the intestine is the most important organ. It not only supplies us with various nutrients, but also brings out harmful compounds. It is very complex, and performs a large number of different functions. That is why it is necessary to treat it with care and pay due attention to its condition.

The intestine can be affected by the inflammatory process, both of the mucous membrane and its walls. The inflammatory process is of a local type, and can spread to the entire length of the intestine. With inflammation, peristalsis is disturbed, the anatomical structure of the mucosa and the functions of this organ change.

Surely, each of us at least once in a lifetime experienced such an unpleasant feeling as intestinal discomfort. This phenomenon can radically change the usual rhythm of our lives.

What it is?

Until now, scientists have not been able to fully understand the factors that cause irritable bowel syndrome. Experts who are studying this issue unanimously agreed that the reason lies in the combination of physical and psychological problems.

There are a number of factors that are considered the most important in the development of this disease.

With IBS, there is no immune or infectious inflammation in the intestines, it is free from tumor formations, there are no helminths in it, but at the same time, a person can often be disturbed by upset stools and severe pain.

It is interesting to know that people over 20 years of age are most often affected by this pathology. The younger generation is not familiar with this disease. Almost half of the patients, aged 40 to 50 years. The syndrome is more common among the representatives of the weak half of humanity. Men are less likely to suffer from this disease. I would like to note that 60% of the sick do not go to the doctor for help, but try to solve the problem on their own, and this is fraught with serious consequences.

Why does this disease occur?

As mentioned above, there is no single, universal reason.

Stressful situations and constant emotional overstrain

It has been observed that this ailment can occur due to exacerbated arousal due to frequent chronic stress, to which young people and women are most often exposed.

In this case, a vicious circle is obtained: a bad emotional state gives rise to irritation of the intestines, and while the disease drives the patient into a dead corner. As a result, depression and the development of diseases of other vital organs.

Doctors sometimes refer to IBS as irritable head syndrome.

Impaired bowel activity

Among the many factors in the development of irritable bowel syndrome in the first place is the violation of its motility. In this case, there is a violation of the transmission of nerve impulses to the muscles of the intestine, due to which the intestinal walls are reduced.

Irrational nutrition is when fatty foods, strong alcoholic drinks, coffee, sweet water with gas, chocolate, and chips predominate in the diet.
Binge eating.
Lack of fiber in food.
Hereditary tendency to this disease. The syndrome is most often diagnosed in people whose parents suffered from the disease.
In 25-30% of patients, the cause of IBS is an intestinal infection.
Women have hormonal imbalances.
Increased sensitivity. People who suffer from this syndrome have a low pain threshold in the intestines. Therefore, they experience pain when it is filled with food or gases.
Gastroenteritis of bacterial origin.
Dysbiosis is the overgrowth of bacteria in the small intestine.

In order for the development of the disease to begin, several factors that were listed above will be quite enough. But, the aggregate can be much more complex.

The more factors, the more pronounced the symptoms of the disease. Although, it is not worth stating this fact for sure. In each individual case, everything is strictly individual.

Types and symptoms of IBS

Types of IBS are distinguished based on the characteristics of fecal masses.

constipation syndrome. In this case, the person may not have a bowel movement for 3 or more days. The patient suffers from severe pain, he does not leave the feeling of a swollen abdomen. The stool may change shape frequently and be contaminated with white or clear mucus. Due to the delay in stool, the patient loses his appetite, he develops nausea, heartburn and an unpleasant taste in the mouth.
mixed option(when constipation alternates with diarrhea).
Variant in which diarrhea predominates. In this case, a person feels the urge to defecate immediately after eating or during a meal. This condition can be observed during the day. With a strong emotional outburst of emotions, involuntary loose stools are possible. With this variant of the development of the disease, a person feels pain in the navel and in the lateral sections of the abdomen.

General symptoms

The manifestations of the disease, as a rule, are especially noticeable after eating and manifest themselves in the form of seizures. For many, symptoms appear for 3 to 4 days, then they completely disappear.

The most commonly observed symptoms:

Spasms and paroxysmal pains that disappear after emptying.
Constipation or diarrhea. These states may alternate.
Swollen, edematous abdomen.
Flatulence.
A sudden desire to go to the closet.
A feeling of "full bowel" that doesn't leave you even after you've just left the toilet.
Feeling of incomplete emptying of the bowels.
There may be mucus in the stool (normally it should not be) and poorly digested food.
Depression, unexplained anxiety.

Medical treatment

Not always a person who has been diagnosed with irritable bowel syndrome can cope with the disease on his own. In most cases, you just need to seek qualified help from specialists.

Treatment for IBS with diarrhea

In this case, doctors do not recommend constantly drinking medicines. This should be done only during an exacerbation of the disease. The following assignments are possible:

Before meals Loperamide, Diphenoxylate. A good effect can be observed from taking Smecta.
From folk remedies: a decoction of their pomegranate peel, sweet cherry, bird cherry and alder fruits.
Sorbents - Enterosgel, Polysorb, Polyphepan, Filtrum STI.
with this variant of the development of the disease, one should not forget about the modulator of serotonin receptors - the drug Alosetron.

Treatment of constipation syndrome

Laxatives that increase the volume of intestinal contents - Naturolax, Mucofalk, Ispagol.
With a delay in stool, you need to take a drug based on lactulose, namely: Duphalac, Normaze, Portolac, Goodluck.
You can take osmotic laxatives: Macrogol, Forlax, Fortrans, Osmogol and the like.
In this case, Tegaserod and Prucalopride are effective.
Mineral water Essentuki No. 17 has a laxative effect.

IBS and dysbacteriosis

Furazolidone, Enterofuril - to suppress pathogenic cocos.
When the disease is mild - Enterol, Baktisuptil.
If there are indications, Cefloxacin, Trichopolum are prescribed.

From spasms and pain

No-shpa, Drotaverine Hydrochloride.
Spazmomen, Ditsitel - reduce pain, regulate intestinal motility.
Espumizan, Dimethicone, Zeolate - remedies for flatulence help well with irritable bowel syndrome.

Antidepressants

At the moment, doctors prefer such drugs as: Befol, Pyrazidol, Fenelzine.

What can't be done?

You can not eat foods that can irritate the intestines, cause fermentation and flatulence, completely eliminate food allergens. You also shouldn't drink hard liquor.

Drawing a conclusion, we can say that with irritable bowel syndrome, drug therapy is not as important as a philosophical attitude to everyday hardships. Do not forget that many diseases are caused by nerves.

A positive attitude and optimism are the main criteria in the treatment of this disease.

Irritable bowel syndrome is a condition that is defined as a functional bowel disorder of a biopsychosocial nature. The basis of the manifestation of this disease is the interaction of two different mechanisms.

This is a psychosocial action and sensorimotor dysfunction, which is characterized by problems with motor activity and visceral sensitivity of the intestine. To ensure high-quality treatment of this condition, a special approach to diagnosis, a differential diagnosis, as well as ensuring the correct course of therapy for the disease are required.

Thus, irritable bowel syndrome is not a disease, but it is a syndrome - a complex of symptoms characteristic of a functional disorder of this gastrointestinal tract. They disturb a person for more than a month. Patients complain of abdominal pain, difficulty with defecation, constipation, diarrhea, mucus in the stool, flatulence.

Causes

Why does irritable bowel syndrome occur, and what is it? Disorders of the gastrointestinal system in IBS is not an independent disease. If the intestines are irritated, then the reasons lie in various functional disorders of the digestive system.

In the event of a relapse or resumption of such a pathological condition as irritable bowel, which has already been treated, it may have completely different causal relationships of digestive disorders.

to the development of this syndrome. often predispose:

frequent stress;
physical or sexual abuse;
intestinal infections;
genetic predisposition.

The peak incidence of irritable bowel syndrome falls on the young part of the population 24-40 years old, although there are frequent cases of manifestations of pathology in adolescence or even in childhood. There are twice as many women with IBS as men.

Irritable bowel symptoms

Irritable bowel syndrome can have three types of symptoms: with a predominance of complaints of abdominal pain and increased gas formation, with a predominance of constipation, with a predominance of loose stools. At the same time, in most patients, the symptoms of IBS can occur in various combinations and change over time.

Therefore, this gradation is rather conditional. The features of the course of the pathology include: a long, non-progressive course of the disease, a variety of manifestations, variability of symptoms, a relationship between deterioration in well-being and stressful situations, as well as errors in the diet.

The main symptoms of irritable bowel syndrome in adults are:

Cramps and pain in the abdomen that go away after a bowel movement. The nature of the pain is wandering, the patient cannot accurately determine the place of its localization.
Constipation (less than three stools per week) or diarrhea (more than three stools per day), in some cases, these conditions may alternate.
Excessive gas formation (flatulence).
Puffiness and.
Sudden and intense urge to stool.
Sensation of incomplete emptying of the bowels after stool.
The appearance of mucus in the feces.

All these signs can be combined with each other. For example, irritable bowel syndrome, accompanied by diarrhea, is often replaced by constipation and vice versa. Symptoms, as a rule, disturb a person for more than three months a year.

Due to the fact that the disease occurs against the background of emotional shock, the above symptoms are often accompanied by headache, weakness, heart pain, back pain, loss of sleep, painful urination, etc. Some pathologies, such as ulcerative colitis or, can disguise themselves as a syndrome irritable bowel, so a differential diagnosis is indispensable.

There are four possible variants of irritable bowel syndrome:

irritable bowel syndrome with constipation(solid or fragmented stools in >25%, loose or watery stools in<25% всех актов дефекации (опорожнения прямой кишки));
irritable bowel syndrome with diarrhea(loose or watery stools >25%, hard or fragmented stools >25%);
mixed form of irritable bowel syndrome(solid or fragmented stools in >25%, loose or watery stools in >25% of all bowel movements);
undetectable form of irritable bowel syndrome(insufficient change in stool consistency to establish a diagnosis of irritable bowel syndrome with constipation, diarrhea, or a mixed form of the disease).

Very often, signs of intestinal irritation occur after eating, at the time of stress, in women during menstruation (or just before the onset of monthly bleeding).

Diagnostics

The Rome Foundation proposed diagnostic criteria for IBS: recurrent abdominal pain or discomfort (onset at least 6 months ago) on at least 3 days per month in the last 3 months associated with 2 or more of the following symptoms:

Pain and discomfort are relieved after defecation;
The onset of pain and discomfort coincided with the change in stool frequency;
The appearance of pain and discomfort coincided with a change in the shape (appearance) of the stool.
Discomfort refers to any discomfort other than pain.

How to treat irritable bowel syndrome

This disease consists of a whole set of symptoms, therefore, in the treatment of irritable bowel syndrome, complex therapy is necessary, which includes:

diet therapy;
lifestyle changes;
pharmacotherapy;
psychotherapy;
physiotherapy;
massage (abdomen or general, self-massage);
physiotherapy exercises.

First of all, you need to establish a mode of life, because. the main cause of the disease is stress. It is necessary to avoid stressful situations, devote more time to rest, sleep, active walks in the fresh air. Diet in irritable bowel syndrome is also an important factor. Nutrition depends on the form of the disease.

If you are more concerned about diarrhea, it is necessary to exclude raw vegetables and fruits, coffee, alcohol, black bread, garlic, legumes from the diet. With flatulence (bloating), limit the intake of carbonated drinks, legumes, cabbage. If you are more likely to suffer from constipation, you should increase the amount of vegetables and fruits consumed, and it is also recommended to drink at least 1.5 liters of fluid per day. Foods that usually cause discomfort should be avoided.

Drugs for the treatment of IBS

The choice of medication support depends on the symptoms of irritable bowel syndrome in a particular patient. The treatment complex may include the appointment of such drugs:

Antispasmodics that relieve pain if it is caused by intestinal hypertonicity (drotaverine, pinaverium bromide, mebeverine, etc.).
M-cholinolytics that reduce spasm and have some antidiarrheal effect (buscopan, belloid, platifillin, riabal, metacin, etc.).
Antidepressants("Imipramine", "Fluxetin", "Citalopram"). Designed to eliminate depression, neuropathic pain and irritable bowel.
Prokinetics - regulators of intestinal motility (metoclopramide, trimedate, tegaserod, itopride, alosetron, debridate, etc.).
Astringent preparations(Smekta, Tanalbin). Assign with exacerbation of diarrhea. For the same purpose, take Maalox, Almagel.
Laxatives - antraglycosides (senna preparations, cofranil, ramnil, regulax, tisasen, etc., can be addictive).
- ("Hilak-Forte", "Laktovit", "Bifiform"). With the help of beneficial bacteria, they improve the functioning of the intestines.

How to treat irritable bowel syndrome, developed on the basis of disorders of the nervous system? In this case, experts recommend increasing stress resistance through the relaxation method, yoga classes and performing special breathing exercises.

Daily regime

Lack of sleep and physical activity significantly worsens the course of the disease. At the same time, the formed habit of emptying the intestines in the morning after breakfast prevents habitual constipation. Promotes regular stools a glass of cold water immediately after waking up in combination with morning exercises, especially exercises "scissors" and "bicycle".

Psychotherapy

Since the frequent transfer of stress is one of the causes of the development of IBS, patients are advised to avoid situations that cause strong emotional upheavals, try not to enter into conflicts and learn techniques that help increase their own stress resistance.

breathing exercises;
the art of meditation;
yoga
Tai Chi and so on.

Hypnotherapy successfully reduces the influence of the subconscious mind on the appearance of certain clinical symptoms of the disease. Psychological training using relaxation techniques can calm and strengthen the nervous system. Yoga classes, special breathing exercises and meditation will teach you how to quickly and properly relax. And physical education and therapeutic exercises will help strengthen the body and improve the nervous system.

Prevention

As preventive measures for irritable bowel syndrome, it is worth noting the normalization of nutrition and lifestyle (balanced diet, regular meals, avoidance of physical inactivity, alcohol abuse, coffee, carbonated drinks, spicy and fatty foods), maintaining a positive emotional environment, taking medicines strictly according to testimony.

Forecast

The condition of patients with irritable bowel syndrome, the effectiveness of treatment and prognosis largely depend on the severity of concomitant disorders of the nervous system. In achieving recovery, overcoming conflicts that are the cause of the formation of a neurosis in a patient is often of decisive importance.

The working capacity of patients with irritable bowel syndrome and the prognosis for this disease largely depend on the severity of concomitant psychoemotional disorders.

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Irritable Bowel Syndrome is a disorder of bowel function, manifested by abdominal pain and / or impaired defecation. Irritable bowel syndrome develops as a result of psychological and other influences on an overreacting intestine.

Irritable bowel syndrome is the most common disease of the internal organs. It can appear at any age, including in children. In women, the disease occurs 2-3 times more often.

Despite the extreme prevalence of irritable bowel syndrome, approximately 75% of the adult population do not consider themselves sick and do not seek medical help.

In the occurrence and development of the disease, psychoemotional disorders are important.

Symptoms of irritable bowel syndrome

The leading manifestations of irritable bowel syndrome are pain, discomfort in the abdominal cavity and stool disorders. Often in the feces you can see a large amount of mucus. Spasm of various parts of the intestine is observed inconsistently and can change localization on different days.

Patients with irritable bowel syndrome have many extraintestinal symptoms, some of which are associated with dysfunction of other digestive organs, and others with disorders of the nervous system and psychological status. The latter cause fatigue, weakness, headaches, decreased appetite, sleep disturbances, palpitations, sweating, attacks of "lack of air", frequent urination, a slight increase in temperature, etc.

With irritable bowel syndrome, there is often a lack of body weight, but it is not associated with a violation of the absorption of nutrients, but with features of the neuropsychic status or with poor appetite.

Qualitative malnutrition is manifested by dryness and flaking of the skin, a change in its color (a kind of dirty gray shade), the appearance of age spots on the face, hands and legs.

There are three main types of irritable bowel syndrome: constipation-dominated, diarrhea-dominant, and pain-dominant.

Diagnostics

The diagnosis of irritable bowel syndrome can be made on the basis of typical presentations in the absence of other bowel disorders that are ruled out by additional investigations.

Currently, for the diagnosis of irritable bowel syndrome in adults, the "Rome criteria-II (2000)" is used: for at least 12 weeks (not necessarily consecutive) in the last 12 months, there is abdominal discomfort or pain that has at least two of the following three characteristics:

decrease after a bowel movement;
the onset is associated with a change in stool frequency;
the onset is associated with a change in the shape of the stool.

Irritable bowel syndrome is diagnosed only if there is a connection of pain and discomfort in the abdomen with a stool. Pain appears before the stool and subsides after a bowel movement, and there is a dependence on changes in the regularity or consistency of the stool.

A number of signs that are not characteristic of irritable bowel syndrome, which may indicate the presence of other diseases.

Rectal bleeding
Decrease in body weight
chronic diarrhea
Anemia
Fever
Onset of the disease in people older than 50 years
Family history (cancer and inflammatory bowel disease in parents)
Pain and diarrhea at night

Rectal bleeding may be due to hemorrhoids; weight loss and subfebrile temperature - manifestations of depression or hypochondriacal syndrome.

Treatment of a syndrome with a predominance of constipation and diarrhea

Treatment of irritable bowel syndrome should be comprehensive.

Diet for the Syndrome

With the predominance of constipation, a diet with the addition of wheat bran is indicated.

All, without exception, patients with irritable bowel syndrome are advised to follow an exclusion diet that does not contain caffeine, lactose, fructose, sorbitol, vinegar, alcohol, pepper, smoked meats, as well as foods that cause excessive gas formation - milk, fermented milk products.

Correction of psychoemotional disorders

A set of measures aimed at improving the functions of the central nervous system and correcting autonomic disorders includes psychotropic drugs, rational psychotherapy. Ideally, a psychoneurologist or psychotherapist should be involved in the diagnosis of psychoemotional disorders and their elimination.

Antibacterial and bacterial preparations

Indications for the use of antibacterial drugs in irritable bowel syndrome are diarrhea, flatulence and abdominal pain.

Apply antibacterial drugs in courses of 7-10-14 days. Recommended

furazolidone,
ersefuril,
metronidazole (trichopolum),
as well as intetrix, nitroxoline and nevigramon.

With diarrhea, the effect is exerted by imodium (loperamide) and alosetron.

With the predominance of constipation, cerucal and motilium are indicated.

With persistent pain, dicetel and duspatalin (mebeverin) have a good effect.

All patients with irritable bowel syndrome during exacerbation of diarrhea are prescribed astringents: smecta, dermatol, tanalbin, white clay, as well as herbal decoctions of a similar effect (chamomile, peppermint, St. John's wort, alder cones, blueberries and bird cherry). For a similar purpose, you can use some antacids (almagel, phosphalugel, maalox) and drugs containing bismuth (venter).

With irritable bowel syndrome with a predominance of constipation, it is necessary to develop the lost morning reflex to defecate and increase the amount of dietary fiber in the diet due to the introduction of wheat bran into it. To stimulate defecation at the first stage of developing a lost reflex, duphalac (lactulose) 1-2 dessert spoons should be prescribed the night before. Train yourself to empty your bowels every morning.

Forecast

The working capacity of patients with irritable bowel syndrome and the prognosis for this disease largely depend on the severity of concomitant psychoemotional disorders.