Description

• Irritable bowel syndrome (IBS) is a common chronic condition affecting the intestine presenting with recurrent, non specific changes in bowel movements and abdominal symptoms diffuse pain, bloating, diarrhoea, constipation and/or both
• The exact pathophysiology is unknown, but may involve changes in gastrointestinal motility, visceral hypersensitivity, and altered gastrointestinal permeability

Types

Four different patterns are seen in the presentation of irritable bowel syndrome

• IBS‑D (diarrhoea is the predominant symptom)
• IBS‑C (constipation is the predominant symptom)
• IBS‑M (mixed diarrhoea and constipation)
• IBS‑A (alternating diarrhoea and constipation)

IBS is characterized by chronic abdominal pain and changes in bowel habits – both of which are typical, but not specific, symptoms

• Abdominal pain: Localization, intensity and Frequency generally vary widely from patient to patient
• Typically related to defecation : pain is often alleviated by defecation , but in few patients it may increase or remain unchanged
• Altered bowel habits: diarrhoea and/or constipation 

Other symptoms

• Passing of mucus, abdominal bloating
• Generalized pain or fatigue
• Disturbed sexual function
• Nausea, reflux, early satiety
• Increased urinary frequency and urgency

Differential diagnosis

• Crohn’s dsease
• Ulcerative colitis
• Colorectal carcinoma

Investigation

Clinical diagnosis is done based on the patient's history

Rome IV criteria for IBS

Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months that is associated with 2 or more of the following criteria

• Pain related to defecation
• Change in stool frequency
• Change in stool form or appearance

Treatments

• Lifestyle changes
• Plenty of fluid
• High‑ fibre foods 
• Avoidance of gas‑ producing foods, Fermentable, short‑chain carbohydrates , Lactose ,Gluten 
• Physical activity
• Stress management - relaxation therapy
• Cognitive-behavioural therapy

Internal medicines

• Kaidaryadi kashaya
• Kalasakadi kashaya
• Vilwadi gutika
• Bhuktanjari gutika
• Dadimashtaka choorna
• Kutajarishta
• Mustarishta
• Sudarshana choorna
• Changeryadi ghrita

Procedure

• Sneha vasti – Pippalyadi anuvasana
• Picha vasti

Department

Kayachikitsa