IRRITABLE BOWEL SYNDROME (IBS)

As you know, irritable bowel syndrome is the most prevalent functional gastrointestinal disorder noted in the general population worldwide. Altered bowel habits characterize it in association with recurrent abdominal pain or discomfort in the absence of detectable structural and biochemical abnormalities of the gut. Its chronic nature, signs, and symptoms which vary periodically from mild to severe have many adverse effects on the sufferer’s quality of life. Young women are affected 2-3 times more often than men. This disorder has no definitive cure but could be controlled by eliminating some exacerbating factors such as certain drugs, stressful conditions, and changes in dietary habits. IBS is sometimes associated with a history of physical or sexual abuse, which is an important aspect of the past, as these patients would benefit from psychologically based therapy. SubCatogarrys:-IBS-D (Diarrhea predominant),   IBS-C (Constipation predominant),  IBS-A (with alternating stool pattern), IBS-PI (post-infectious)

Contributing factors

  • Behavioral & psychosocial (Anxiety, Depression, Somatisation, Neurosis, Panic attacks etc.)
  • Small intestinal bacterial overgrowth or Gut dysbiosis
  • Chemical food intolerance to FODMAPs (fermentable oligo-di-monosaccharides and polyols)
  • Serotonin dysregulation (5-HT)

Clinical features:

  1. Recurrent abdominal discomfort
  2. The pain of colicky or cramping nature felt in the lower abdomen
  3. Pain relieved by defecation
  4. Abdominal bloating
  5. Mucus in stool
  6. Infrequent pellety stools in association with proctalgia (in IBS-C)
  7. Frequent defecation with low-volume stools (in IBS-D)

Investigations:

The diagnosis is strictly clinical in nature. But the following can be done,

  1. Full blood count
  2. Colonoscopy- (to exclude colorectal cancer)
  3. Gastroscopy- (to exclude IBD)

Rome III Criteria for diagnosis of IBS

Recurrent abdominal pain or discomfort on at least 3 days per month in the last 3 days per month, in last 3 months, associated with 2 or more of the following: –

  • Improvement with defecation
  • Onset associated with a change in frequency of stool
  • Onset associated with a change in the appearance of stool

Line Of Management in Ayurveda

In the ayurvedic system of medicine, the concept of psychosomatic disorders has been widely discussed. According to acharyas, sharira and manasika doshas are interdependent on each other. One follows the other, so the diseases which are derived from them, also cannot exist without one another. Hence while understanding the pathogenesis of IBS, you must give importance to annavaha, purishavaha, rasavaha and manovaha srotodushti.

There is no single disorder in Ayurveda that can precisely co-relate with IBS. Some conditions in particular, quite practically similar to IBS in clinical practice are Atisara, Pravahika, and Grahani.

The important factors which play a significant role are the malfunctioning of Agni and Vata dosha Specifically Samana and Apana Vata along with the substantial contribution of the mind.

  • Vasti, the multidimensional therapy, is one among the panchakarma especially advised for correction of Vata dosha.
  • To overcome stress and other psychological issues, Ayurveda advocates the use of Sirodhara, Takradhara, Yoga, Pranayama, etc.

Dietary & lifestyle management: –

  1. Eat regularly and avoid missing meals
  2. Na ativilambitham (Eat not too slowly), Na atidrutham (not too quick), take time to eat
  3. The use of jeeraka (Cumin), Takra (Buttermilk), Dadima (Pomegranate), Ushnodaka (warm water) are appreciated.
  4. Ensure adequate hydration and avoid carbonated & caffeinated drinks
  5. Reduce alcohol intake
  6. Avoid foods with artificial sweeteners
  7. Consider a wheat-free and lactose exclusion diet
  8. Do adequate vyaayama (exercise).
  9. Maintain regular sleep patterns.

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