What is irritable bowel syndrome?
Irritable bowel syndrome (or irritable bowel syndrome) is a functional digestive disorder. This means that it has no organic (visible) cause and that the symptoms are produced by alterations in the function or sensitivity of the digestive tract. The fact that the cause is not visible does not mean that it does not exist. It is something similar to what happens with most headaches: the fact that there is no brain tumor, intracranial hemorrhage or other lesions does not indicate that the patient does not have a headache. What happens is that the alterations are not visible to the naked eye or with conventional tests: they are microscopic, related to certain neurotransmitters, determined by the type of nerve connections, etc.
Does this mean that the causes are not known?
No. A great deal is now known about the mechanisms by which irritable bowel disease occurs. What happens is that different factors act in a complex manner. In some cases, digestive movement alterations predominate: there are spasms that produce pain, the transit is too slow (and they suffer constipation), or it is too fast (and they have diarrhea) and, sometimes, it is irregular (and they alternate constipation with diarrhea). In other patients the origin is an excess of bacteria inside the intestine, which can produce increased gas and abdominal bloating. Dietary factors also play a role, and celiac disease and certain carbohydrate malabsorptions should be ruled out. In addition, many patients have an excessively sensitive digestive tract, causing pain with stimuli that healthy subjects do not find painful. In this regard it must be said that emotional factors can contribute to increased symptoms. It is not that they make up the discomfort, it is that their digestive tract malfunctions and becomes more sensitive as a result of stress, anxiety or depression.
How do the tests in patients with irritable bowel syndrome work?
Since there is no organic lesion, all tests are usually normal. The patient undergoes blood tests, ultrasound, colonoscopy, etc. and everything is normal. Then the doctor says: “Don’t worry, there is nothing wrong with you”. And the patient thinks: “How can I have nothing if my stomach hurts a lot and I never go to the bathroom properly? It can’t be. Of course there is something. There is a functional digestive disorder, which is not dangerous but enormously annoying and greatly alters the quality of life: it does not kill but it does not let you live normally.
Is it treatable?
Yes, but there is no single treatment. It is necessary to look for the possible causes in each case. This is a job to be done jointly by doctor and patient. Some cases can be treated with spasmolytics, others with antibiotics or probiotics; sometimes medications that act directly on the pain are necessary; and it is not uncommon to need the support of a nutritionist or psychologist. It is essential to work as a team and seek the best solution individually. On the other hand, more and more research is being done on this syndrome and, hopefully, new treatments will be on the market in the near future.