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Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic or recurrent abdominal pain or discomfort, which is associated with disturbed bowel function and feelings of abdominal distention and bloating.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic or recurrent abdominal pain or discomfort, which is associated with disturbed bowel function and feelings of abdominal distention and bloating. It is the most common reason that patients seek medical advice from primary care physicians and gastroenterologists. The prevalence of IBS reaches 7%-10% worldwide depending on the criteria used for diagnosis. It is a common gastrointestinal disorder, affecting 10%-15% of the population in developed countries. IBS is associated with a significant reduction in health-related quality of life.

Subtypes

  • IBS-C (with constipation)
  • IBS-D (with diarrhea) à 40-60% of cases
  • IBS-M (mixed)
  • IBS-U (undetermined

Common Symptoms

  • Abnormal stool frequency (>3x/day or <3x/week)
  • Abnormal stool form (loose and watery or lumpy and hard)
  • Abnormal stool passage (frequency, urgency, feeling of incomplete evacuation)
  • Passage of mucous
  • Bloating sensation or abdominal distension

Causes

  • Intestinal motility and intestinal smooth muscle functional disturbance
  • Visceral hypersensitivity
  • Alterations in the brain-gut axis due to chronic Stress
  • Psychological factors: PTSD, Trauma
  • Gastrointestinal hormones
  • Dysbiosis: Abnormal intestinal microbiome
  • Post-infection inflammation
  • Genetic factor

Treatment

  • Mind-body practices to reduce stress
  • Elimination diet
  • Low FODMAP diet

Acupuncture and IBS

A meta-analysis of six randomized controlled trials suggests that acupuncture improves the symptoms of IBS, including abdominal pain and distension, sensation of incomplete defecation, times of defecation per day, and state of stool. It has been suggested that acupuncture might modulate pain in IBS by two actions: (1) modulation of serotonin pathway; and (2) modulation of mood and affection in the higher cortical center. Acupuncture is believed to alter visceral sensation and motility by stimulating the somatic nervous system and the vagus nerve in IBS.

Herbal Medicine and IBS

Studies suggest that Peppermint to be a safe and effective treatment for IBS and improve abdominal pain and bloating sensation. Another Meta-analysis showed that Chinese Herbal Medicine improved global IBS symptoms and abdominal pain and distension.