Irritable bowel syndrome

Scientific evidence from recent years suggests there are many different factors involved in developing this disease:

• social and psychological factors such as stress and depression
• social and cultural factors
• genetic factors
• dietary factors
• changes in gut microbes
• gastrointestinal infections
• being female
• an increase in central and peripheral sensitivity to visceral pain 

It is currently considered to be a disorder caused by an imbalance in the gut-brain-microbe axis This imbalance negatively affects the functioning of the intestinal barrier and activates the digestive system’s immune and nervous system. This creates visceral hypersensitivity and motor disturbances.

Symptoms

The most common symptoms are:

• Recurring abdominal pain at least once a day during the last three months, combined with changes to bowel movements affecting the frequency and consistency of stools.

It is classified according to consistency:

•  mostly constipated
•  mostly diarrhoea
•  mixed
•  indeterminate

Who is affected by irritable bowel syndrome?

It affects 7.8% of the population in Spain and twice the number of women compared to men: 1. IBS is the reason for 10-15 % of primary care appointments and 25-30 % of gastroenterology consultations. Over 50 % of patients are affected by other pain conditions such as fibromyalgia, headache or pelvic pain, and also by other gastrointestinal disorders such as dyspepsia or by anxiety disorders and depression.

Diagnosis

IBS is diagnosed by fulfilling a set of clinical criteria based on symptoms and on the exclusion of other organic causes that may act in a similar way.

Diagnostic criteria known as the Rome IV criteria have been established by medical consensus by committees of experts. The following are required for diagnosis:

• blood and stool sample
• endoscopies
• intestinal biopsies
• food allergy and intolerance tests  

Typical treatment

When determining treatment, it is important patients understand the chronic and fluctuating nature of the disease. To draw up an appropriate treatment plan, the doctor must identify the dietary and psychic-social causes of the illness.

Specific treatments are beginning to be introduced for IBS, such as linaclotide, eluxadoline and lubiprostone, but not all are available in Spain. There are also many treatments designed to control symptoms, such as anti-spasmodic drugs, laxatives and anti-diarrhoeals.