Irritable bowel syndrome (IBS) is a functional GI disorder characterized by abdominal pain and altered bowel habits in the absence of specific organic pathology. Patients often experience the onset of symptoms as young adults and most patients have their first symptoms before the age of 35. An estimated 20–50% of GI referrals are due to IBS. In the West, female patients predominate; in India however most reporting patients are young men, probably because of social inhibition in females.
Rome IV defines IBS as: Recurrent abdominal pain on average at least 1 day a week in the last 3 months, beginning at least 6 months ago associated with two or more of the following:
- Related to defecation;
- Associated with a change in a frequency of stool;
- Associated with a change in form (consistency) of stool
Abdominal pain or discomfort in IBS improves after passing stool and / or has onset with a change in frequency or form of stool. Pain frequently is diffuse commonly in lower abdomen and without radiation. It may be mild enough to be ignored or it may interfere with daily activities. Despite pain the appetite of the patient is often normal, and pain is mostly limited to waking hours, thus patients are not sleep deprived.
Altered bowel habit is the most consistent clinical feature in IBS. Four bowel patterns may be seen with irritable bowel syndrome. These patterns include
- IBS-D (diarrhoea predominant),
- IBS-C (constipation predominant),
- IBS-M (mixed diarrhoea and constipation), and
- IBS-A / IBS-U (alternating diarrhoea and constipation/ Un-sub typed).
Within 1 year, 75% of patients change subtypes, and 29% switch between constipation-predominant IBS to diarrhoea-predominant IBS. The most common pattern is constipation alternating with diarrhoea. IBS patient may complain of constipation with symptoms of hard stools of narrow caliber, painful or infrequent and does not respond to laxatives. Initially episodic, constipation may eventually become continuous. Most patients also complain of incomplete evacuation, thus leading to repeated attempts at defecation in a short span of time. IBS-C patients may have week or months of constipation interrupted with brief periods of diarrhoea. Diarrhoea usually is small volume, with evacuation preceded by urgency or frequent defecation. Urgency after eating food is common, as is alternation between constipation and diarrhoea. Nocturnal diarrhoea does not occur in IBS. Diarrhoea may be aggravated by emotional distress or eating. Stool may be accompanied by passage of mucus. Bleeding per rectum is not a feature of IBD unless haemorrhoids are present.
Patients with IBS frequently complain of abdominal distension and increased belching or flatulence, all of which they attribute to increased gas. The reason often is impaired transit and reduced tolerance of intestinal gas loads.
IBS has both physiological and psychological determinants. The severity of IBS is multi-dimentional depends upon the patient perception due to bio-psycho-social factors. IBS severity may also differ in same individual over time. About 50% of IBS patients referred to hospital meet criteria for a psychiatric diagnosis including anxiety, depression, somatisation and neurosis.
Why choose Homoeopathy for IBS
Conventional treatments typically do not get to the root of the problem or provide anything but partial symptomatic relief in IBS as it only treats the clinical symptoms of disease not the ‘individual’ suffering from them. Homoeopathy on the other hand considers no patient is alike in physical, mental and behavioural patterns. It invariably attaches greatest importance to the cause as opposed to the end result. The physical make-up of the patient as well as intellectual and mental characteristics is studies to find the suitable medicine. Being holistic and free from side effects, Homoeopathy is a good treatment option for IBS with high success rate.