April 12, 2012
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Irritable Bowel Syndrome - A condition that is defined as a functional bowel disorder that has biopsychosocial character. The basis of this disease is considered to be manifestations of the interaction of two different mechanisms. This psychosocial effects and sensomotoric dysfunction, which is characterized by problems with the motor activity of the intestine and visceral sensitivity. To ensure high-quality treatment of this condition requires the implementation of a special approach to the diagnosis, differential diagnosis, as well as ensuring the proper course of treatment of the disease.
The prevalence of irritable bowel syndrome
Most often suffer from this disease in the working-age population: people 25 to 40 years. The presence of symptoms of the disease in people who have already crossed the threshold of sixty, makes experts doubt such a diagnosis.
Irritable bowel syndrome - a disease which has a high incidence in many countries. However, about two-thirds of people who complain of symptoms of this disease, generally do not seek skilled care. The disease is equally common among representatives of both sexes.
Symptoms of Irritable Bowel Syndrome
Under the irritable bowel syndrome should understand the presence of a constant set of functional disorders that are going on not less than twelve weeks during the past year. They expressed the feeling of pain and discomfort in the abdomen. Irritable bowel syndrome in a patient takes place abdominal pain . Its intensity can be a not very high (the pain is quite tolerant and non-permanent) and particularly intense (sometimes unbearable pain, recalls intestinal colic ). Very often, the pain appears after eating, takes place abdominal distention Amplified peristalsis . After bowel movements and flatus pain often subsides. At night it is mostly the patient is not worried.
Furthermore, in humans occurs simultaneously change in stool frequency and consistency. Over 25% of the disease these symptoms are accompanied by no less than two permanent symptoms of bowel function. A case in point is about flatulence , The presence of mucus in the stool, change of bowel movements (presence tenesmus, urgency, feeling of incomplete emptying of the bowel, the need for efforts at defecation).
Also, for a person with irritable bowel syndrome is characterized by the manifestation of some other signs. So, his complaints are often volatile and have a recurrent character; disease progression is observed, a person does not lose weight, it does not develop anemia . fever But under the influence of stress disorder may worsen.
Furthermore, there may be communication with the other of the syndrome disorders functional nature, such as vegetative fatigue syndrome . IBS stomach . neuroses . irritable bladder syndrome and other conditions.
For irritable bowel syndrome characterized by chronic relapsing disease, but without progression. Typically, the disease does not cause serious complications. As a consequence, it is a favorable prognosis. However, it should be noted that this disease significantly affects the quality of life, reducing their ability to work, worsening sleep, rest, sexual life.
Today, the disease is considered a common disease among people. But in view of the vagueness of its symptoms are very often patients do not turn to art, thereby aggravating the condition.
Diagnosis of Irritable Bowel Syndrome
Accepted define three different types of flow of irritable bowel syndrome, depending on symptom, which predominates. This disease, which dominates flatulence and abdominal pain; disease with predominant constipation ; irritable bowel syndrome, which dominates diarrhea .
In the process of diagnosis originally specialist should eliminate most common reasons for intestinal irritation occurs. This, above all, chronic effects of malnutrition, the reception of drugs. Among the food products that affect the bowel as stimuli to be noted alcohol, fatty food, coffee products which are formed from gases. Also negatively on bowel function may be affected too excessive eating during banquets, changing the usual approach to nutrition because of your travel. Among the drugs often irritate the intestines laxatives, iron preparations, potassium, bile acids, antibiotics and etc.
In addition, the symptoms of irritable bowel syndrome occur in women with certain physical states - in the period before menstruation, when pregnancy , during menopause .
Symptoms of the disease appear and after a strong stress intellectual and emotional character, excitement, fear. However, the normalization of the mental state of the person they disappear.
Therefore, the specialist should carry out a detailed survey of the patient and assess the presence of persistent set of clinical symptoms. The frequency of this is about the pain in the abdomen, which are combined with impaired functioning of the distal parts of the intestine and can not be attributed to violations of morphological or metabolic nature. Consequently, organic pathology excluded.
As the symptoms for which the doctor should pay special attention to the determination of the disease, it should be noted violation of transit and defecation. Thus, the chair should be considered a pathology that occurs more than three times a day or less than three times per week. As a rule, irritable bowel syndrome diarrhea occurs more often in the morning, after a breakfast person. Approximately half of the patients at the same time point out that there is mucus in the stool. At the same time, diarrhea at night, the presence of blood in the stool, severe weight loss Human exclude the diagnosis of "irritable bowel syndrome".
When to see a doctor, patients, usually express complaints that could be related to the three groups.
Firstly, there are neurological disorders and vegetative nature : Poor sleep, or drowsiness , Migraine headaches, a feeling of a lump in the throat, impotence . dysmenorrhea and others. Such a state is characterized for about half of the patients.
About eighty percent of patients expressed complaints about the signs digestive diseases : They manifest nausea and vomiting, belching, sensation of pain in the right upper quadrant, and others.
A relatively small number of patients (15 - 30%) complain psychopathological disorders - Anxiety, depression, hysteria, phobia, panic attacks al.
In the presence of such complaints and therefore suspected irritable bowel syndrome patient appoint sigmoidoscopy and colonoscopy. Such studies allow to exclude many of the morphological and metabolic disorders. Sometimes the exclusion of other diseases also nominated holding Biopsy mucosa.
In general, diagnosis of this disease is quite complex, so it is usually carried out in stages.
So, at the first stage the doctor will determine a preliminary diagnosis. Further, it is important to allocate a symptom which is dominant, and thus determining what the clinical phase of the disease. The third stage of the diagnosis - differential diagnosis. Next, the doctor prescribes a series of tests: clinical and biochemical blood tests, ultrasound studies coprological pelvic and abdomen, colonoscopy and barium enema.
After all studies patients received therapy for up to at least six weeks. After that re-evaluates the attending physician diagnosis. So, if the treatment gives the desired effect, we are talking about the final diagnosis. If this effect is absent, there is a need for additional studies.
Treatment of Irritable Bowel Syndrome
The main program of therapy diseases account for two terms. Initially, the attending physician shall designate the primary course of treatment, and the second step is carried out basic therapy.
The patient should tune in long-term therapy. Thus, the primary course lasts for about 6-8 weeks, the second phase may take about three months. The doctor determines the remedies, guided by the severity of the disease, its main symptom, the patient's mental state.
For qualitative and effective treatment, it is important that the patient follow some dietary principles of nutrition. So, in his diet should not contain caffeine, fructose, lactose, alcohol, spicy foods, vinegar, sorbitol. Excluded are those products that encourage a high level of gas production. Also, diarrhea is often provokes smoking. So from this it is desirable to get rid of a bad habit. People who have constipation predominant, the most optimal method of supply will plant diet . It is important to include in the daily diet fiber, drink plenty of fluids. Lots of fiber include fruits, some vegetables, wheat bran. This should always be fed in appropriate circumstances, slowly, taking food. Sometimes the patient is recommended to use special additives in foods that contain fiber.
Thus, the patient has to realize that special diets that must be respected in each case does not exist. However, to control the symptoms of irritable bowel syndrome is possible, eliminate from the diet food that provokes symptoms - diarrhea, constipation, and others.
In some cases, psychosocial support and diet are an effective treatment for irritable bowel syndrome, and further medical treatment is generally not required.
In the primary treatment in more severe cases, the emphasis is on eliminating the symptoms of disease, as well as on the validation of initial diagnosis. During the subsequent treatment of the base products are selected depending on whether the patient predominant symptom. Mainly used drugs having antispasmodic . Antidiarrheal or laxative action. Sometimes effective and are small doses tricyclic antidepressants . Some experts prescribing practices probiotics , I.e. drugs which contain the useful microorganisms.
Often at this stage, using the methods of physical therapy, special physical therapy and others. The important role played by the use of psychotherapy, relaxation techniques.
However, the most important principle in the treatment of irritable bowel syndrome is the use of individual approaches. After all, the only therapies of this disease does not exist.
Furthermore, in the treatment of irritable bowel syndrome uses some traditional methods of therapy. So, through the use of peppermint oil can be quickly removed intestinal spasms. In addition, the treatment can be prepared herbal, consisting of equal parts of valerian, St. John's wort, yarrow, chamomile, peppermint. These herbs need to pour boiling water and infuse overnight. Eat small portions of the infusion should be several times a day. Also, traditional medicine offers the use of other herbs to prepare infusions and decoctions. Effective impact on the condition of patients with licorice root, flax seeds, burnet root, buckthorn bark, cherry fruit, blueberry leaves, grass and fennel seeds, cumin seeds.
Prevention of irritable bowel syndrome
Disease prevention is aimed at preventing the manifestation of its symptoms. This, above all, the correct approach to nutrition. Depending on the prevalence of symptoms (constipation, diarrhea) should follow the principles of power described above.
Important everyday drinking regime: the use of the day for at least six glasses of water will help to normalize the condition of the intestine. However, the water should not drink while taking food.
Furthermore, it should lead a quiet life, as much as possible to prevent stressful situations, constant physical activity. To improve the condition if you have problems with bowel function may even elementary walk in the fresh air, which lasts at least thirty minutes. However, should walk every day.
A regular quality vacation, the ability to fully relax and restore emotional balance.
When taking any medicines, it is important to monitor the condition of the intestine. If there is a violation of it, should talk to a doctor about the possibility of replacing the drug.
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