IBS - Irritable Bowel Syndrome
Symptoms of irritable bowel syndrome include stomach cramps, bloating, diarrhoea and constipation. These may come and go over time.
IBS is characterized by abdominal pain and altered bowel habit in the absence of a specific and unique organic pathology. This means that there are symptoms of colon irritation/damage, but no specific disease can be identified and there is vast variation between patients.
Causes for IBS have not yet been identified, but current research suggests:
The myoelectric activity (electric potential of muscles - how muscles contract and relax, in this case to push food along) of the colon is composed of background slow waves with spike potentials.
Colonic dysmotility in irritable bowel syndrome manifests as variations in slow-wave frequency and a blunted, late-peaking, postprandial response of spike potentials.
This causes delayed meal transit (slow digestion) in patients prone to constipation, and in accelerated transit in patients prone to diarrhoea.
Current theories suggest generalized smooth muscle hyperresponsiveness - the muscle cells overreact to the electric currents.
IBS symptoms may be a result of an increased pain response to colon activity
Rectosigmoid and small bowel balloon inflation produces pain at lower volumes in patients than in controls.
Notably, hypersensitivity appears with rapid but not with gradual distention.
Patients who are affected describe widened dermatomal distributions of referred pain. Sensitization of the intestinal afferent nociceptive pathways that synapse in the dorsal horn of the spinal cord provides a unifying mechanism.
IBS is both more common and more debilitating in patients with panic disorder, major depression, anxiety disorder, and hypochondriasis.
The psychopathology and stress caused by these disorders may contribute to IBS.
This is particularly concerning as IBS symptoms will worsen these conditions, which may in turn worsen the IBS.
Both colonic inflammation and small bowel inflammation have been discovered in a subset of patients. These studies are still in early stages.
Alterations in the intestinal biome
Small bowel bacterial overgrowth has been heralded as a unifying mechanism for the symptoms of bloating and distention.
The faecal microflora (bacteria in poo) also differs among patients with irritable bowel syndrome compared to those without.
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