Small Intestine /Enteric Bacteria Not A Major Factor For Irritable Bowel Syndrome (IBS) /Spastic Colon

Small Intestine /Enteric Bacteria Not a Major Factor For Irritable Bowel Syndrom

IBS is also called functional bowel syndrome, irritable colon, spastic bowel and spastic colon. It's not the same as inflammatory bowel diseases like ulcerative colitis.rritable bowel syndrome involves a combination of abdominal pain and alternating constipation and diarrhea. There are many possible causes. For instance, there may be a problem with muscle movement in the intestine or a lower tolerance for stretching and movement of the intestine. There is no problem in the structure of the intestine.

Fortunately, unlike more serious intestinal diseases such as ulcerative colitis and Crohn's disease, irritable bowel syndrome doesn't cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer. In many cases, you can control irritable bowel syndrome by managing your diet, lifestyle and stress.

In people with IBS, the intestines squeeze too hard or not hard enough and cause food to move too quickly or too slowly through the intestines. IBS usually begins around age 20 and is more common in women. Irritable bowel syndrome is extremely common, but only a small number of people seek treatment.

It is among the most common gastrointestinal problems in the United States. Between 7 percent and 20 percent of Americans experience symptoms suggestive of IBS, such as abdominal pain, constipation and diarrhea, but many shy away from discussing the problem and end up missing out on effective treatment for the syndrome. Longstanding symptoms of abdominal pain, altered bowel function, urgency to defecate, bloating and a feeling of incomplete evacuation in the absence of structural or biochemical abnormality characterize the syndrome. Over last few decades, there have been major advances in our understanding of the pathophysiology of IBS.

By definition, no mechanical, biochemical, or overt inflammatory condition explains the symptoms. Validated, symptom-based criteria for the diagnosis of irritable bowel syndrome are highly predictive in the absence of alarming symptoms such as weight loss, fever, and intestinal bleeding. The pain or discomfort experienced by patients with irritable bowel syndrome often leads to health care use and a decreased quality of life.

The precise cause of IBS remains unclear, but several different factors appear to play a role. Abnormalities in contractions, secretion and sensation of the intestine and colon are common in IBS. Further, function and sensation of the bowel can be influenced by factors including diet, stress, depression, anxiety and infections of the bowel.

The walls of the intestines are lined with layers of muscle that contract and relax as they move food from your stomach through your intestinal tract to your rectum. Normally, these muscles contract and relax in a coordinated rhythm. But if you have irritable bowel syndrome, the contractions are stronger and last longer than normal. Food is forced through your intestines more quickly, causing gas, bloating and diarrhea.

Moreover, it has been shown that psychological factors such as anxiety and stress are important in the symptomatology of irritable bowel syndrome (IBS) patients (Gwee et al. 1996). Intestinal degranulation of mast cells can result in the release of mediators such as histamine, serotonin and cytokines, known to facilitate the response of afferent fibres inducing a range of systemic symptoms like visceral pain, the major symptom described in IBS patients

Meal ingestion is often associated with exacerbation of gastrointestinal symptoms in subjects with irritable bowel syndrome [IBS]. Abnormalities of 5-HT release after a meal might explain some of the postprandial symptoms associated with the irritable bowel syndrome [IBS].Sometimes the symptoms of IBS may be triggered by another illness such as stomach flu or other infections causing diarrhea. About a quarter of patients with IBS are also lactose intolerant. A lot of patients with IBS end up on these very bland diets.

Previously data suggested that small-bowel overgrowth by enteric bacteria has been cited as a cause of the symptoms.The symptoms of irritable bowel syndrome are similar to those of small intestinal bacterial overgrowth. The purpose of this study was to test whether overgrowth is associated with irritable bowel syndrome and whether treatment of overgrowth reduces their intestinal complaints.

But most recently Swedish researchers reported in the medical journal Gut that an abnormally high number of bacteria in the small intestine does not appear to be a major factor affecting the symptoms of irritable bowel syndrome.

"The data do not support an important role for small intestinal bacterial overgrowth, according to commonly used clinical definitions, in IBS," senior investigator Dr. Magnus Simren told Reuters Health.

Simren and colleagues at Sahlgrenska University Hospital, Gothenburg, note that a high rate of bacterial overgrowth has been reported in patients with IBS, but these observations were based on tests that only indirectly measured bacteria levels.

They therefore assessed small intestinal bacterial overgrowth by a direct test -- bacterial culture of small-bowel test samples -- among 162 patients with IBS and 26 healthy subjects. Cultures revealed the exact same rate of intestinal bacterial overgrowth in both groups, 4 percent.

Signs of intestinal movement abnormalities were seen in 86 percent of patients with overgrowth and in 39 percent of patients without overgrowth. The investigators also observed that movement abnormalities did not reliably predict altered small-bowel bacterial levels.

With effective counseling, dietary and lifestyle intervention, and use of over-the-counter or prescription medications, IBS can be effectively managed.Tips on controlling IBS


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