Irritable bowel syndrome( IBS) unites under the general name various violations of the process of muscular contractions of separate areas of the intestine, which advance pieces of food along the esophagus, accompanying the processes of absorption and secretion in the intestine. Irritable bowel syndrome is characterized by pain in the abdomen, disorders in acts of defecation.
To the development of IBS, a number of factors act separately or in combination with each other. These include:
- Disturbances in the interaction between the central nervous system and the system that regulates the activity of internal organs.
- Dysbacteriosis.
- Changes in the suction mechanism.
- Mental disturbances.
- The nutritional deficiencies of substances that can not be processed in the human body.
- Factors of social and emotional order.
In this case, an unjustifiably strong impulse enters the brain, provoking a reciprocal impulse to internal organs of excessive intensity. The incoming signal disrupts the normal process of gastric contraction, responsible for the process of digestion of food throughout the digestive tract. These disorders cause abdominal pain, constipation, or diarrhea. In addition, IBS disease can be accompanied by the phenomena of involuntary discharge of gases, bloating, increased tension in the act of emptying, sensation of a crowded abdomen, mucus secretions during bowel evacuation. Pain syndrome can be of different intensity and different nature, increasing after eating and decreasing after going to the toilet. Increased gas production leads to false calls for defecation.
Constipation, periodic or persistent, may continue with irritable bowel syndrome from several days to several weeks. With the prevalence of diarrhea, loose stools usually appear after taking breakfast. In addition, IBS can be accompanied by headache, chill fingers, a feeling of lump in the throat, and psychoemotional disorders. Despite the fact that IBS is not complicated by perforation, intestinal obstruction and other organic disorders, irritable bowel syndrome has a negative effect on the quality of life. For example, irritable bowel syndrome is second only to colds among causes leading to disability. The vicious circle is created by the mutual influence of stressful situations and IBS on each other.
classification The aim of developing a general classification on an international scale is to enable the systematization, analysis and comparison of data on all diseases and deaths that occurred at different times and throughout the world. Transforming the verbal formulation of the diagnosis and other health-related issues. Classification is used to solve many tasks related to the organization of health care and for all epidemiological purposes. Currently, the Tenth revision is in force. According to the ICD, irritable bowel syndrome has the code K58.For IBS, the ICD code 58 has a different numerical designation depending on the type of feces. For IBS with diarrhea, the ICD code is 58.0, and for the irritable bowel syndrome without diarrhea, the code is K58.9.
The difficulty in classifying IBS is that it is impossible to define it on the basis of etiological or non-physiological signs. This is due to the fact that many disorders of the digestive system, for example, chronic pancreatitis, infectious diarrhea, ischemic colitis, show similar symptoms. For the classification of irritable bowel syndrome, a list of symptoms known under the name of Roman criteria III is used.
Symptoms of irritable bowel syndrome
In accordance with these criteria, it is possible to suspect IBS, when the first symptoms appear about six months ago, and during the last three months at least two of the three main signs of irritable bowel syndrome are permanently present. It can be:
- the disappearance of pain after the act of defecation;
- pain symptoms associated with acts of defecation;
- on the background of pain marked changes in the form and consistency of faeces.
In the presence of irritable bowel syndrome, diarrhea or constipation may occur, with changes in the shape of the feces - in pellets, in the form of a "pencil chair" or unformulated watery. The very process of defecation can be difficult with pain, with false urge to defecate, a feeling of incompleteness of the act of defecation. In addition, there may be manifestations of flatulence - bloating, gas leakage. There are also signs of irritable bowel syndrome that are not related to functional disorders. These include:
- depression, a state of unreasonable anxiety;
- fatigue;
- headache;
- pain in the back;
- heart rhythm disturbances;
- problems with urination( frequent urge, pain, increased urination, etc.):
- pain in sex, decreased sexual desire.
The need to classify and establish a diagnosis is also related to excluding unreasonable surgical intervention.
What is IBS, briefly speaking, it can be defined as an excessive sensitive bowel, acute and painful reaction to ordinary life situations or associated with emotional stress. The main theory that explains the appearance of functional disorders of the digestive tract is a violation of normal perception of pain in IBS patients. The mechanism of the development of the disease lies in the fact that the brain receives, exaggerated a strong impulse and a response signal directed to the intestine is also unreasonably excessively strong. Excessively strong impulse leads to impairment of the motility of the organ, which is expressed in pain in the abdomen, bloating, constipation or diarrhea.
Treatment of IBS
According to the clinical classification, three types of IBS syndrome are distinguished based on the predominant factor:
- abdominal pain;
- followed by constipation;
- diarrhea.
Depending on the option, the direction of treatment is chosen. By severity, the course of the syndrome is divided into mild, moderately severe and severe. The formation of visceral hypersensitivity is influenced by such factors as intestinal infection, stressful situation or physical trauma. The action of these factors together with functional disorders of the gastrointestinal tract causes a syndrome of spinal hyperexcitability in which the reflex response in the opening is perceived as painful. That is, patients with IBS develop a hypersensitive perception of pain with the expansion of the intestinal wall with a small amount of gas.
In general, the disease develops in the large intestine, but there are cases of the development of irritable small intestine syndrome. In irritable bowel syndrome without diarrhea, it is possible to use laxatives of mild effect, so as not to increase the effect of irritant factors on the mucosa. In general, this pathology is characterized by leakage over a very long time.
Chronic irritable bowel syndrome is characterized by alternating periods of exacerbation and calmness, but the progression of the disease is mitigated in exceptional cases. However, it is very rare to completely get rid of all the symptoms, but it is possible to significantly improve the quality of life by observing medical recommendations. According to statistics, irritable bowel syndrome mainly develops in metropolitan areas, among those who lead a sedentary lifestyle and are inactive in physical terms.
How to distinguish IBS from other diseases?
Despite similar symptoms, the main difference between the syndrome and other diseases of the digestive tract is that there is no morphological basis. For example, peptic ulcer of the stomach is characterized by defects in the mucous membrane, inflammation of the lungs - thickening of the area of the lung tissue, and so on. But in the presence of the syndrome, no changes that can be observed are not recorded. Another feature of leaking, you can call the mandatory presence of abdominal pain. In addition, there are a large number of various patient complaints, including gastrointestinal complaints, and concluding with psychoneurological complaints.
In patients with irritable bowel syndrome there may be signs characteristic of neurocirculation with dystonia of different syndromes. Treatment of irritable bowel syndrome is complex and consists of the following actions:
- Effects on the psychoemotional scheme.
- Balanced rational nutrition, depending on the type of IBS according to ICD-10.
- Enhance physical activation.
- Medication for the normalization of intestinal motility.
- Physiotherapy and folk methods.
The effectiveness of treatment largely depends on the stabilization of the patient's psychoemotional condition. And this in turn is associated with a change in human behavior, aimed at increasing the stability of the psyche. In this respect, physical exercises speed up getting rid of the symptoms of irritable bowel syndrome, and also promote mental health, normalization of the psychoemotional state.
Exercises for irritable bowel syndrome
The usefulness of regular exercise was shown by a special clinical experiment conducted by Dr. Riach Sadik from Sweden. Divided into two groups, people diagnosed with IBS had a habitual lifestyle for several months, and another group received moderate exercise( cycling, jogging, etc.) weekly( 3-5 days about an hour).The sports group noted improvement in 43% of participants. Physical exercises strengthen the hormonal and nervous system, reduce gas production and relieve constipation.
To relieve pain during spasms in the intestine, brush reflexotherapy is very effective. To do this, press the thumb of the left hand on the point under the axis of the little finger, separated by two finger widths from the wrist fold, raised up the right hand. Then, sliding your thumb to the outer edge of the palm, move slowly along the straight line to the base of the hand.
One of the most effective techniques is training on a special device called biofeedback. In this case, the device teaches a person how to relieve nervous tension and slow heartbeat. After a while, to the state of relaxation, a person learns to pass by himself. To relieve nervous tension, breathing exercises and yoga are recommended. When breathing exercises are regulated the activity of the intestines, breathing should be diaphragmatic or abdominal. Diaphragmatic breathing means the process of breathing, when the breath is made with the muscles of the stomach, and with a deep breath, the stomach descends by itself, relaxing the abdominal muscles, promoting calm and normal intestinal peristalsis. The main thing in respiratory gymnastics is its regular holding and for a long time.
In general, the definition of irritable food tract syndrome was not immediately detected. For the first time the symptoms of this disease were described as early as the end of the nineteenth century, but then this condition was designated as "mucous colitis."Later, the disease with such symptoms was called spastic colitis, bowel neurosis and other names. For the first time, the term determining what Irritable Bowel Syndrome means was introduced in 1967, De-Lor.
In the world, there are 14 to 30 percent of people diagnosed with IBS of the intestine, but among patients for gastrointestinal reasons this figure is almost 70%.At the same time, a relatively small number of patients turn to specialized care. In general, middle-aged people are irritated, but if the first symptoms of the syndrome are diagnosed in people over 50 years of age, a detailed examination should be carried out to exclude organic disease.