Oh shit!
https://www.telegraphindia.com/1170116/jsp/knowhow/story_130445.jsp
Your Health - Dr. Gita Mathai
IBS (irritable bowel syndrome) is an irritating and sometimes incapacitating disease. It produces painful abdominal cramps, bloating, explosive watery diarrhoea, or, conversely, constipation with pellet-like stools. These symptoms can occur at any time during the day. This makes people fearful about leaving the house. As they near the door, a feeling of incomplete evacuation of stool, or an overwhelming desire to return to the toilet delays departure. This can be a life-changing delay when examinations, interviews or timed departures (planes, trains) are scheduled.
Fifty per cent of India is between 20 and 50 years of age. A conservative estimate is that around 10 million of these people suffer from IBS. More women than men are affected. All of them are not symptomatic all of the time. The illness has spontaneous exacerbations and remissions. The uncertainty of if and when IBS will occur interferes with a tension-free lifestyle in young adults during their most productive years.
In order to diagnose IBS, abdominal discomfort should last at least three days a month for three months. Passing stool should relieve the pain. The frequency and consistency of the stool should be altered. There may be a feeling that bowel movements are incomplete. Mucous may be present in the stool. This confuses the picture and often leads to an erroneous diagnosis of amoebic dysentery.
Most of the time the diagnosis of IBS is made clinically. A few simple tests to rule out amoebae, giardia and other parasites in the stool may be done and are usually enough. Other tests such as endoscopy, barium studies, X-rays, CT scans, lactose tolerance tests and breath analysis may be done if there are other findings, like onset after the age of 50, weight loss, bleeding from the rectum, nausea, vomiting, abdominal pain or diarrhoea at night or anaemia. This may show that the symptoms are due to more serious illnesses such as ulcerative colitis, Crohn's disease or cancer.
The exact reason for IBS is not known. It tends to run in families, though that may be a combination of genes and environment. For some reason, the nerves supplying the colon become hypersensitive and respond inappropriately to even mild stimulation. Instead of slow, steady, progressive contractions and relaxations, the movements become uncoordinated. This produces spasms and pain. The movement may slow down, causing bloating and constipation. There may be intestinal hurry with diarrhoea. There may be overgrowth of bacteria in the intestines with release of toxins, causing the bloating. Since it is commoner in women, it may be due to female hormones. There is an intestine-brain nexus under the control of chemicals such as serotonin and gastrin. The chemicals may be out of sync. All of these are merely theories - none have been proved.
The symptoms improve:
• If you eat on time, with short gaps between each meal
• If you drink at least eight cups of water a day
• If you restrict caffeinated and aerated drinks
• If you avoid processed foods with additives, colours and preservatives
• If you do not eat the seeds or skin of fruits
• If you give up some syrups and artificial sweeteners that contain sorbitol, which aggravates the symptoms.
Certain foods may be a trigger for the disease and are best avoided (this is a very individual phenomenon). Stress too can worsen symptoms. Aerobic exercise for 20-30 minutes a day, vigorous enough to build up a light sweat, combined with relaxation (yoga) and meditation also help.
Dr Gita Mathai is a paediatrician and author of Staying Healthy in Modern India. Mail your questions to yourhealthgm@yahoo.co.in
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