IBS

WHAT IS IBS?

Irritable bowel syndrome (IBS) is a gastrointestinal (GI) disorder characterized by altered bowel habits in association with abdominal discomfort or pain in the absence of detectable structural and biochemical abnormalities. It is a disorder that affects your lower GI (gastrointestinal) tract, this includes the small intestine and large intestine (colon). It is diagnosed when a person has belly pain or spasm associated with a change in the appearance or frequency of their bowel movements. When you have IBS, your colon looks normal, but it does not work the way it should. IBS is a common functional bowel disorder that generates a significant health care burden and can severely impair quality of life and is the most commonly diagnosed gastrointestinal condition.

SYMPTOMS

  • Abdominal Pain or Discomfort
  • Bloating
  • Diarrhea
  • Constipation
  • Fatigue

PATHOPHYSIOLOGY

  • Altered gastrointestinal motility
  • Visceral hypersensitivity
  • Post infectious reactivity
  • Brain-gut interactions
  • Alteration in fecal micro flora
  • Bacterial overgrowth
  • Food sensitivity
  • Carbohydrate malabsorption
  • Intestinal inflammation

WHEN TO SEE A DOCTOR?

See your doctor if you have a persistent change in bowel habits or other signs or symptoms of IBS. They may indicate a more serious condition, such as colon cancer. More-serious signs and symptoms include:

  • Weight loss
  • Diarrhea at night
  • Rectal bleeding
  • Iron deficiency anemia
  • Unexplained vomiting
  • Difficulty swallowing
  • Persistent pain that isn’t relieved by passing gas or a bowel movement

CAUSES

The exact cause of IBS isn’t known. There are many possible causes of IBS, and they differ from person to person. This means that some people can have the same symptoms, but different causes of their IBS. Some experts think that if you have IBS, your colon or small intestine may be more sensitive than normal. That means it has a strong reaction to things that should not normally affect it.

When you have IBS, your colon muscles begin to move and tighten uncontrollably (spasm) after only mild stimulation or after normal events such as:

  • Eating
  • Swelling or bloating from gas or other material in the colon
  • Some medications
  • Some foods
  • Women with IBS seem to have more symptoms during their periods. This could mean that the chemicals (reproductive hormones) released during a woman’s menstrual cycle may increase IBS symptoms.

TRIGGERS

Symptoms of IBS can be triggered by:

FOOD. The role of food allergy or intolerance in IBS isn’t fully understood. A true food allergy rarely causes IBS. But many people have worse IBS symptoms when they eat or drink certain foods or beverages, including wheat, dairy products, citrus fruits, beans, cabbage, milk, and carbonated drinks.
STRESS. Most people with IBS experience worse or more frequent signs and symptoms during periods of increased stress. But while stress may aggravate symptoms, it doesn’t cause them.

RISK FACTORS

Many people have occasional signs and symptoms of IBS. However, risk factor include:

  • IBS occurs more frequently in people under age 50.
  • IBS is more common among women. Estrogen therapy before or after menopause also is a risk factor for IBS.
  • Have a family history of IBS. Genes may play a role, as may shared factors in a family’s environment or a combination of genes and environment.
  • Psychological Stress

COMPLICATIONS

Diarrhea and constipation that happen with IBS can cause hemorrhoids. If you already have hemorrhoids, they may get worse.

Your quality of life may be affected by IBS, because the symptoms may limit your daily activities.

TESTS & DIAGNOSIS

Your healthcare provider will decide how much testing you need depending on your age and symptoms. Diagnostic tests may include the following:

  • Blood tests
  • Urinalysis and urine culture
  • Stool culture
  • Stool testing for blood (fecal occult blood test)
  • Upper endoscopy also called EGD (esophagogastroduodenoscopy)
  • Abdominal X-rays
  • Abdominal ultrasound
  • Colonoscopy
  • Breath test. This test may diagnose bacterial overgrowth that some belief can lead to IBS.

TREATMENTS

  • EXERCISE
  • DIET MODIFICATION
  • Low FODMAP Diet

RECIPE

  1. Beef Pasties

Ingredients 

  • 300g of gluten free plain flour
  • 1 tsp xanthan gum
  •  1 tsp salt
  • 50g butter
  • 1 egg
  • 1 extra egg for glazing and extra flour for rolling out the pastry
  • 500g of beef skirt
  • 100g of celeriac
  • Fresh Thyme
  • Salt and pepper

Preparation

  • Add the flour to a bowl and salt and pepper and xanthan gum – stir well into the flour.
  • Cut up the butter into cubes and rub into the flour, add the egg and extra water if required and bring the
  • pastry together knead the pastry till smooth then chill.
  • While the pastry is chilling chop the meat and celeriac into small cubes add the thyme break the second egg
  • into a bowl and whisk.
  • Roll out the pastry in between cling film cut out disks about the size of a small plate.
  • Add a small amount of meat and celeriac and thyme to half the disk add salt and pepper.
  • Brush egg around the pastry edge on the half of the disc with filling bring over the other half of the disk to
  • make the lid and crimp
  • Brush the top of the pastry with egg wash
  • Cook at 165°C

  1. Crustless Quiche

Ingredients

  • 13g/1tbsp garlic infused oil
  • 250g fresh spinach
  • 200g cherry tomatoes
  • 4 eggs
  • 60g gluten free flour
  • 2g/1/2tsp baking powder
  • 4g/1tbsb fresh thyme
  • Salt and pepper to season
  • 300 ml lactose free milk
  • 200g cherry tomatoes
  • 30g cheddar cheese
  • 30g parmesan

Preparation

  • Preheat oven to 180°C
  • Grease a flan tin/quiche dish.
  • Heat the oil in a separate pan and add the spinach Sauté until wilted stirring all the time, remove from the heat and allow to cool.
  • In a large bowl, mix together the eggs, flour, baking powder and thyme. Season, then whisk in the milk.
  • When the spinach is cooled, chop into small pieces and combine the spinach with the egg mixture.
  • Pour the filling into the prepared tin or dish. Don’t overfill!
  • Top with the tomatoes and both cheeses.
  • Place in the oven and bake for 30-35 minutes or until the quiche has set and turns golden.
  • Garnish with the remaining cherry tomatoes and serve hot or cold.

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