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[EN] Good Gut - part 1

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Did you know that your intestines are extremely sensitive? So sensitive that we often even ‘feel’ with our gut first. Infatuation, sadness, fear: they are all feelings that you ‘sense’ with your gut. A hypersensitive gut however, can be quite annoying. Yet today 10-15% of all people suffer from such a hypersensitive or irritable bowel. It probably won’t kill you, but - as the name suggests - it can be quite an annoying thing.


What's in a name?

Irritable bowel syndrome, or short IBS. Don't worry, we're not talking about a life-threatening condition here, at least not in the physical sense of the word. But the fact is that it is extremely annoying (hence the name irritable bowel syndrome) and it can have a huge impact on one’s quality of life. Mentally quite 'killing' that’s for sure!


Between one’s ears!

In science, IBS is called a functional condition because the gut’s function is disturbed. However, without a clear physiological cause. People with IBS report having a variety of bowel issues like, pain and bloating. In addition, the intestine seems hypersensitive to all kinds of stimuli, but the intestine looks healthy from the inside. And so it is often said that this disorder happens between one’s ears. But is that really the case?

Fotografie: Jeroen Jorissen

A clutter of wet poo, dry rabbit droppings, pain and other inconveniences

IBS is an extremely diverse condition and has quite a variation of and manifestations. Diagnosis is initally made based on a combination of disturbed bowel habits in combination with pain*, but there are also many other complaints, even presented 'in the mix'.


Primary complaints

  • First of all there is the fluffy predominant variant: IBS with diarrhea (IBS-D). There is an IBS variant with predominantly constipation, i.e. the “dry” or “hard” variant: IBS-C. A third variant is characterized by mixed bowel movements: diarrhea, alternated with constipation (IBS-M). Finally, there is the unspecified variant: IBS-U. This one does not clearly indicate a disturbed bowel movement, but there are definitely other intestinal complaints, such as persistent pain in combination with bloating, for instance.

  • In order to get to a hard diagnosis of IBS, the above disturbed bowel habits must be accompanied by pain or discomfort in the abdominal region for quite some time; that is at least 3 times a month over the past 3 months*.

  • Although IBS has been within the diagnostic scope of the specialist for about a century, its stricter diagnostic criteria were made about 50 years ago, primarily based on the absence of other diseases. Today, there are specific criteria that can help a specialist make a positive diagnosis [1].


Secondary complaints and the mind

  • Although pain and disturbed bowel movements are important for the diagnosis of IBS, the average person with IBS also suffers from a wide range of other intestinal complaints, for example bloating, flatulence, mucus excretion in stools or the feeling of an incomplete defecation.

  • Irritable bowel syndrome primarily causes a lot of physical discomfort, which can result in a negative quality of life in the long run. Therefore, the mental consequences of continuous abdominal turmoil should not be underestimated: many people with IBS gradually experience anxiety or feelings of depression [2].


Patients often visit many specialists - ranging from GP to internist to psychologists - before being sent home with the diagnosis “IBS”. In such cases, the general advice is usually: “ you’d better learn to live with it”.

Treatment after treatment

At this point, it is not yet fully understood how exactly IBS develops and the underlying causes are not entirely clear. It may be clear that IBS is rather difficult to diagnose and a person with fragmented symptoms as mentioned above, in all kinds of combinations, might therefore be labelled with IBS.


Its diversity is exactly what makes treating this syndrome such a challenge. Due to the diversity of complaints, it can be difficult to target a treatment. As a result, patients often visit many specialists - ranging from GP to internist to the psychologists - before being sent home with the diagnosis “IBS”. In such cases, the general advice is usually: “ you’d better learn to live with it”.


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*DISCLAIMER - If you are suffering form intestinal complaints, like the ones described above, please consult a doctor to get to a valid diagnosis. Never draw conclusions based on the info you read here, because there might be a different cause for your complaints!

Sources

1. Rome III criteria for the Irritable Bowel Syndorm via http://www.romecriteria.org/assets/pdf/19_RomeIII_apA_885-898.pdf

2. Thijssen A, Jonkers D, et al. Dysfunctional cognitions, anxiety and depression in irritable bowel syndrome. J Clin Gastroenterol. 2010;44 (10)


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