Monday, 2 April 2012

Irritable Bowel Syndrome – Leaves Confusion In Its Trail

I like Easter. I am not sure if it’s a result of my over a decade-old intimate relationship with the Kwahus or simply because unlike Christmas the excesses are overshadowed by the worship of the Almighty. This statement may not apply to my friends and relatives up the mountain.
We are all quite prayerful at Easter but we certainly do not completely neglect the food, drinks including “atemuda” and other vices. Food and drinks remind me of Irritable Bowel Syndrome (IBS). The mere length of the name gives the impression that the medical community is confused by this condition. Does it not sound like a bowel that is angry with the rest of the body? That is exactly the way it behaves.
What is IBS and how does it present?
IBS differs from other abdominal conditions because it is characterized by abdominal pain with diarrhoea or constipation or both. These inconvenient conditions come back again and again.
In addition to the above, others may have the following:
• Mucous in stools
• “Gas” and visibly bloated belly.
• Nausea
• Feeling of early fullness after meals
• Indigestion
IBS will generally not harm you but the frequency of bowel movements for instance may interfere with everyday life. If you get frequent diarrhoea you may not want to leave home or even socialize and you may not even want to eat out since food is probably the number one trigger.
Causes, Risk factors and triggers
The exact cause is not known. I think it is worth knowing that such a cantankerous condition exists and could be the reason for all your woes. That sprint to the toilet soon after every meal and sometimes as many as five times within an hour may be tell-tale signs of IBS.
We are all at risk but it is commoner in women as well as those with a family history of IBS. It may coexist with depression and anxiety and has often been associated with stress. Stress certainly causes IBS to flare up. Unfortunately the inconveniences caused by this condition may cause a lot of stress and the vicious cycle continues.


Some triggers have been identified and include;
• Eating a meal – no specific foods have been universally linked to IBS. You will need to use a trial and error method to determine which ones cause you distress. It is a brilliant idea to keep a food diary.
• Hormonal Changes – many women with IBS are known to have severe pain and extreme change in bowel movement during their menses.
• Some Medication
Diagnosing IBS
There are currently no standard tests. Your healthcare professional may order tests to rule out other causes of your symptoms. Often referred to as a diagnosis of exclusion because when we are unable to find any other reason Irritable Bowel Syndrome may come to our rescue.
In recent times guidelines exist which, once met makes the probability of one having IBS very high. In such a scenario it may not be necessary to carry out too many tests. You will need to give your doctor detailed information to help him make a diagnosis.
If you have any of these conditions then you may have something other than IBS and further tests are mandatory:
• Symptoms start after age 50
• There is blood in the stools
• Family history of colon cancer
• Weight loss
• Night time diarrhoea
• Symptoms that start soon after taking antibiotics
Management of IBS
It is heartwarming to know that if you have IBS then “You are SAFE. Only one of two things can occur. Either you learn to cope with the condition or you “die” of embarrassment. If you learn to cope, then ONLY one thing can occur. You will live to a ripe old age because IBS does not harm the gut in anyway.”
The management of IBS targets the symptoms to a large extent:
1. Diet Changes;
a. Modifying your meals should be the first stop.
b. Increase your fibre and water intake
c. Probiotics (“friendly” bacteria) as found in some yoghurts are quite beneficial.
d. You may avoid caffeine, alcohol, fatty foods, chocolate, nuts, dairy products and vegetables such as broccoli, beans and cabbage (that is a long scary list. Note that you will reintroduce these foods gradually so that you can pick out your nemesis)
2. Exercising
a. This will decrease stress and improve digestion
b. Also the general wellbeing that is a trademark of exercising helps you cope better
3. Medication
a. Drugs to relieve constipation, stop diarrhoea and manage depression all have a role to play in IBS
4. Psychotherapy
a. Various forms have been tried including hypnosis and relaxation techniques
Dear reader, this Easter when you join the millions of Ghanaians who will be praying, do remember to say a word of prayer for me. Pray for peaceful elections and prosperity in our land and finally remember to pray for divine wisdom to take responsibility for your health. Get your walking shoes and go walking, of course only after spending time with God.

Source:
Dr. Kojo Cobba Essel
Moms’ Health Club

References:
1. www.webmd.com
2. Harvard Medical School, Patient Education Center.

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