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Pathologic Conditions

Irritable Bowel Syndrome

Irritable bowel syndrome or spastic colitis (IBS) is a common disorder that affects the large intestine. Irritable bowel syndrome is a chronic condition that usually causes abdominal pain and cramps, bloating, gas, diarrhea, and constipation.

Despite its symptoms, irritable bowel syndrome - unlike ulcerative colitis and Crohn's disease, which are inflammatory bowel diseases - does not cause changes in the intestinal tissues and does not increase the risk of colon cancer.

Symptoms of irritable bowel syndrome

The signs and symptoms of irritable bowel syndrome can vary greatly from person to person. Among the most common symptoms are the following:

  • Abdominal pain or cramps
  • Βloating
  • Gas
  • Diarrhea or constipation or sometimes, alternating periods of constipation and diarrhea
  • Mucus in the stool

Irritable bowel syndrome is a chronic condition, with periods of worsening and remission of symptoms or even their complete disappearance.

Causes of irritable bowel syndrome

It is not known exactly what causes irritable bowel syndrome. The intestinal wall is made up of smooth muscle fibers that contract and relax at a certain rate as food is transported from the stomach. In patients with irritable bowel syndrome, these contractions may be stronger and last longer, causing gas, bloating, and diarrhea, or, conversely, contractions of the intestine may be weak and delay the passage of food, creating hard stools and constipation.

Provocations that cause symptoms of irritable bowel syndrome

Foods: The role of food allergy or food intolerance in irritable bowel syndrome is not yet fully understood, but many patients experience more severe symptoms when they eat certain foods. A wide range of foods has been implicated: chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated soft drinks, alcohol, and more. The majority of patients (approximately 75%) with IBS develop food intolerance to at least one food and most of them have multiple food intolerances. The most common intolerances include dairy (40-45%) and cereals (40-60%). It has been shown that many patients who follow certain food exclusion diets (elimination diets) to which they are intolerant, notice a significant clinical improvement. Interestingly, many patients with IBS have symptoms that suggest vasomotor instability (such as palpitations, hyperventilation, fatigue, excessive sweating, and headache), which is associated with a food allergy or intolerance reactions.

Anxiety: Most patients with irritable bowel syndrome experience an exacerbation of symptoms during periods of high stress. But while stress can make symptoms worse, it does not cause them.

Hormones: Because women have twice the possibility to have irritable bowel syndrome, researchers believe that hormonal changes play a role. Many women find that their symptoms are more pronounced during or around menstruation.

Other diseases: Sometimes other diseases, such as episodes of acute gastroenteritis or small intestine bacterial overgrowth (SIBO), can cause irritable bowel syndrome.

Risk factors for irritable bowel syndrome

Age: Irritable bowel syndrome usually occurs in people under the age of 45.

Sex: Women are almost twice as likely to suffer from the condition.

Family history: People who have a family member with irritable bowel syndrome are at increased risk of developing the syndrome.

Mental health: Anxiety, depression, personality disorders, and others can be risk factors for developing the syndrome.

Complications of irritable bowel syndrome

Avoiding certain foods can lead to a reduction in the intake of nutrients (vitamins and minerals). But the most important complication is the impact of the syndrome on the overall quality of a patient's life, which can even lead to depression.

Diagnosis of irritable bowel syndrome

Because there are usually no signs for a definitive diagnosis of irritable bowel syndrome, the diagnosis is often made by the exclusion of other pathological conditions. To aid in the diagnosis, two sets of diagnostic criteria have been developed.

Rome criteria. According to these criteria, there must be certain signs and symptoms for the diagnosis of irritable bowel syndrome. The most important is abdominal pain and discomfort that lasts at least three days a month for the last three months and is accompanied by two or more of the following symptoms: improvement in symptoms after defecation, changes in the frequency of bowel movements, or changes in stool composition.

Manning criteria: These criteria focus on relieving pain with defecation, the presence of incomplete bowel movements, the presence of mucus in the stool, and changes in the composition of the stool. The more symptoms there are, the more likely it is that irritable bowel syndrome occurs.

Some signs or symptoms that may indicate another, more serious condition include:

  • First appearance after the age of 50
  • Weight loss
  • Bleeding from the rectum
  • Fever
  • Nausea or recurrent vomiting
  • Abdominal pain occurring at night
  • Persistent diarrhea that wakes you up from sleep
  • Iron deficiency anemia
Laboratory tests for the diagnosis and monitoring of irritable bowel syndrome 

EnteroScan IBS / IBD: It includes a series of specialized and important laboratory tests to investigate irritable bowel syndrome.

TrophoScan: It is the laboratory blood test for food intolerance to the most common foods that can trigger the symptoms of irritable bowel syndrome.

Tests for Celiac disease: Celiac disease, i.e. sensitivity to gluten, can cause symptoms similar to those of irritable bowel syndrome. These tests help to exclude (or confirm) this disorder. Basic Test for Celiac Disease and Complete Test for Celiac Disease. Coeliac Disease Basic Profile, Coeliac Disease Extended Profile

Lactose Intolerance Test, Molecular Detection: Lactase is an enzyme necessary for the digestion of sugars present in dairy products. Lack of this enzyme can cause problems similar to those caused by irritable bowel syndrome, including abdominal pain, gas, and diarrhea.

Additional tests: Due to the malabsorption but also the exclusion from the diet of different food groups, very often there are deficiencies in vitamins and micronutrients, resulting in the emergence of many pathological conditions associated with these deficiencies. Vitamin Basic Profile, Vitamin Comprehensive Profile, Micronutrient Elements Profile

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