Irritable bowel syndrome (IBS) is one of the most common ailments of the
bowel (intestines) and affects an estimated 15% of persons in the US. The
term, irritable bowel, is not a particularly good one since it implies that
the bowel is responding irritably to normal stimuli, and this may or may not
be the case. The several names for IBS, including spastic colon, spastic
colitis, and mucous colitis, attest to the difficulty of getting a
descriptive handle on the ailment. Moreover, each of the other names is
itself as problematic as the term IBS.
IBS is best described as a functional disease. The concept of functional
disease is particularly useful when discussing diseases of the
gastrointestinal tract. The concept applies to the muscular organs of the
gastrointestinal tract; the esophagus, stomach, small intestine,
gallbladder, and colon. What is meant by the term, functional, is that
either the muscles of the organs or the nerves that control the organs are
not working normally, and, as a result, the organs do not function normally.
The nerves that control the organs include not only the nerves that lie
within the muscles of the organs but also the nerves of the spinal cord and
brain.
Some gastrointestinal diseases can be seen and diagnosed with the naked eye,
such as ulcers of the stomach. Thus, ulcers can be seen at surgery, on
x-rays, and at endoscopies. Other diseases cannot be seen with the naked eye
but can be seen and diagnosed with the microscope. For example, celiac
disease and collagenous colitis are diagnosed by microscopic examination of
biopsies of the small bowel and colon, respectively. In contrast,
gastrointestinal functional diseases cannot be seen with the naked eye or
with the microscope. In some instances, the abnormal function can be
demonstrated by tests, for example, gastric emptying studies or antro-duodenal
motility studies. However, these tests often are complex, are not widely
available, and do not reliably detect the functional abnormalities.
Accordingly, by default, functional gastrointestinal diseases are those
involving the abnormal function of gastrointestinal organs in which
abnormalities cannot be seen in the organs with either the naked eye or the
microscope.
Occasionally, diseases that are thought to be functional are ultimately
found to be associated with abnormalities that can be seen. Then, the
disease moves out of the functional category. An example of this would be
Helicobacter pylori infection of the stomach. Many patients with mild upper
intestinal symptoms who were thought to have abnormal function of the
stomach or intestines have been found to have an infection of the stomach
with Helicobacter pylori. This infection can be diagnosed by seeing the
bacterium and the inflammation (gastritis) it causes under the microscope .
When the patients are treated with antibiotics, the Helicobacter, gastritis,
and symptoms disappear. Thus, recognition of Helicobacter pylori infection
removed some patients' diseases from the functional category.
The distinction between functional disease and non-functional disease may,
in fact, be blurry. Thus, even functional diseases probably have associated
biochemical or molecular abnormalities that ultimately will be able to be
measured. For example, functional diseases of the stomach and intestines may
be shown ultimately to be caused by reduced levels of normal chemicals
within the gastrointestinal organs, the spinal cord, or the brain. Should a
disease that is demonstrated to be due to a reduced chemical still be
considered a functional disease? I think not. In this theoretical situation,
we can't see the abnormality with the naked eye or the microscope, but we
can measure it. If we can measure an associated or causative abnormality,
the disease probably should no longer be considered functional.
Despite the shortcomings of the term, functional, the concept of a
functional abnormality is useful for approaching many of the symptoms
originating from the muscular organs of the gastrointestinal tract. This
concept applies particularly to those symptoms for which there are no
associated abnormalities that can be seen with the naked eye or the
microscope.
While IBS is a major functional disease, it is important to mention a second
major functional disease referred to as dyspepsia, or functional dyspepsia.
The symptoms of dyspepsia are thought to originate from the upper
gastrointestinal tract; the esophagus, stomach, and the first part of the
small intestine. The symptoms include upper abdominal discomfort, bloating
(the subjective sense of abdominal fullness without objective distension),
or objective distension (swelling, or enlargement). The symptoms may or may
not be related to meals. There may be nausea with or without vomiting and
early satiety (a sense of fullness after eating only a small amount of
food).
The study of functional disorders of the gastrointestinal tract often is
categorized by the organ of involvement. Thus, there are functional
disorders of the esophagus, stomach, small intestine, colon, and
gallbladder. The amount of research on functional disorders has been focused
mostly on the esophagus and stomach (such as dyspepsia), perhaps because
these organs are easiest to reach and study. Research into functional
disorders affecting the small intestine and colon (for example, IBS) is more
difficult to conduct and there is less agreement among the research studies.
This probably is a reflection of the complexity of the activities of the
small intestine and colon and the difficulty in studying these activities.
Functional diseases of the gallbladder, like those of the small intestine
and colon, also are more difficult to study.
Most individuals are surprised to learn they are not alone with symptoms of
IBS. In fact, irritable bowel syndrome (IBS) affects approximately 10-20% of
the general population. It is the most common disease diagnosed by
gastroenterologists (doctors who specialize in medical treatment of
disorders of the stomach and intestines) and one of the most common
disorders seen by primary care physicians.
Sometimes irritable bowel syndrome is referred to as spastic colon, mucous
colitis, spastic colitis, nervous stomach, or irritable colon.
Irritable bowel syndrome, or IBS, is generally classified as a "functional"
disorder. A functional disorder refers to a disorder or disease where the
primary abnormality is an altered physiological function (the way the body
works), rather than an identifiable structural or biochemical cause. It
characterizes a disorder that generally can not be diagnosed in a
traditional way; that is, as an inflammatory, infectious, or structural
abnormality that can be seen by commonly used examination, x-ray, or blood
test.
Irritable bowel syndrome is understood as a multi-faceted disorder. In
people with IBS, symptoms result from what appears to be a disturbance in
the interaction between the gut or intestines, the brain, and the autonomic
nervous system that alters regulation of bowel motility (motor function) or
sensory function.
Irritable bowel syndrome is characterized by a group of symptoms in which
abdominal pain or discomfort is associated with a change in bowel pattern,
such as loose or more frequent bowel movements, diarrhea, and/or
constipation.
Treatment options are available to manage IBS—whether symptoms are mild,
moderate, or severe.Bowtrol has been formulated to address the needs of colon health and contains Bifidobacterium infantis (Lactospore). For more information on Bowtrol visit: http://www.bowtrol.com |
