By Eulalee Thompson 
More women than men are affected by irritable bowel syndrome (IBS), caused by a disturbance in the muscle movement in the large intestines.
STABBING LOWER abdominal pains, constipation, flatulence and feeling full are symptoms that should alert patients that all's not well in the gastrointestinal system. Presenting with these symptoms, irritable bowel syndrome (IBS) is one of the conditions which the medical practitioner would want to rule out.
"It is not going to kill you but it will make your life miserable," said a Trinidad and Tobago gastroenterologist, Dr. David Coomansingh. He was making a presentation on IBS at a journalists' workshop held recently in Florida, United States. The workshop was sponsored by the pharmaceutical company, Novartis, whose interest in IBS stems from the fact that they manufacture a drug called Zelmac (tegaserod maleate), used in the treatment of the condition.
Dr. Coomansingh said however that although the condition may not kill, its socio-economic impact is great - in terms of health care costs, absenteeism from work and reduced performance at work.
He says, for example, that studies are indicating that IBS patients make more visits to physicians each year than non-IBS patients; and, they are not only visiting for gut problems but for other problems. Dr. Coomansingh said that in the United States of America, there are about three million physician visits each year and doctors write about two million prescriptions per year.
IBS patients, he said, are also a drain on the health care system chalking up costs that are greater than - those patients with other gastrointestinal (GI) conditions (such as ulcerated colitis, liver disease) and those with non-GI symptoms (such as diabetes).
Another aspect of cost according to Dr. Coomansingh is that, based on studies, many patients with IBS are missing days from work. Adolescents were missing days from school.
"They either had belly pains, they were bloated, they were having diarrhoea. An average of 1.7 days lost from work per month. Patients did go to work but they couldn't work a full day - 46 per cent of them, couldn't manage a full day. And think of you being an employer, with an employee who cannot manage eight hours, you are talking about money," he said.
The condition of abnormally increased spontaneous movement of the small and large intestines, Dr. Coomansingh said is generally made worse by emotional stress. Under stress the body activates "the fight or flight" response - produces substances such as adrenaline and cortisol. These substances increase blood pressure, heart rate, muscle strength and oxygenation, reducing the oxygenation of the skin and the intestine.
"There is a great interaction between the brain and the gut - just the thought of doing your driving test or your examinations produces symptoms - indigestion, gas, dispepsia, bloating, diarrhoea. So you cannot separate the two. These patients have an increased awareness and altered perception of their situation (the location of the pain); they have a higher prevalence of preceding stressful events and I think that this is one of the major reasons why patients consult not so much for the pains but because of the preceding stressful life events, their pains get worse, because they have altered perception and awareness of their situation," he said.
Studies are also showing a higher prevalence of sexual and physical abuse in IBS patients - so in their early life, they might have been exposed to certain psychological and physical trauma which manifest itself later on in life.
Prevent & control IBS
Add more fibre to the diet - fibre passes through the stomach and intestine without being absorbed; because it is not absorbed, it contributes to more consistent stools and stimulates the bowel's movement, contributing to regular bowel habit. Sources of fibre include green leafy vegetables, fruits, wheat bran, whole grain cereals, oatmeal, legumes. Prune juice produces a laxative effect.
Drink at least five additional glasses of water each day to help fight constipation.
Learn to identify and manage stress - some of the symptoms of stress include lack of sleep, headaches, digestive symptoms and profuse sweating of the hands. Regular exercising will help you to better respond to stress.
Medication - drugs are available to relieve symptoms of irritable bowel syndrome. Zelmac being promoted by Novartis, works with those patients with constipation (but not the diarrhoea phase).
Causes of IBS
Stress - it is one of the most important causes of irritable bowel syndrome (IBS). Anxiety is often difficult to express consciously so they are expressed through certain organs such as the large intestines.
Diet - the composition of the diet influences the triggering of the symptoms of irritable bowel. The colon absorbs a large amount of water and so adequate water is an important part of diet. Diets poor in fibre and high in fats and soft drinks should be avoided.
Hormones - feminine hormones may cause some predisposition to this disorder. For the same reason, throughout the menstrual cycle, women with irritable bowel syndrome have variations in their symptoms.
Alcohol - produces irritation in the stomach and intestinal lining. It should be avoided.
