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Health 1020
Don Vernon
Maya Louise Barton
30 November 2016
Pathology of Irritable Bowel Syndrome
Pain in the abdomen, discomfort upon eating, and diarrhea are just some of the irritating
and exhausting symptoms experienced by those who have Irritable Bowel Syndrome. In Western
Society, this illness affects 10-20% of the population of adults and adolescents. Thats about one
in 7 people! Being such a common disease, it is interesting that not much is known about the
causation. This report will cover symptoms of IBS, the characteristics to diagnose, some of the
possible causes and correlated evidence of Irritable Bowel Syndrome, and to finish, some of the
options for treatment.
Individuals with Irritable Bowel Syndrome can experience symptoms such as, but not
limited to, diarrhea, constipation, sharp or dull stomach pain, sharp or dull intestinal pain,
distended abdomen, inflammation of the bowel, and a persistent urgency to defecate. Along with
these symptoms, occasionally one could also experience extra symptoms like sexual dysfunction,
mucous in the stool, nausea, heartburn, and a change in urinary frequency. Every one of these
symptoms can be a great stressor on a person trying to lead an ordinary and painless life; The
stress of being ill can bring about more symptoms in itself!
IBS is a common disorder among the population. It accounts for 41% of Functional
Gastrointestinal illnesses. Some of the symptoms are similar to those of IBD, Celiac Disease, and
other similar illnesses; necessitating that other illnesses must be ruled out before diagnosing IBS.
In order to be diagnosed with IBS, according to The Rome III criteria, an individual must have

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had recurrent abdominal pain for 3 or more days a month for 3 continuous months. The
discomfort will include at least two of the following: Pain relieved by defecation, the onset of the
pain associated with a change in the frequency of the stool and/or the form of the stool. There are
four different Bowel Pattern sub-types of IBS. IBS-D is diarrhea predominant, IBS-C is
constipation predominant, IBS-M is a mix of diarrhea and constipation, and IBS-U is used to
categorize patterns that do not follow any of the previous three. Only a small minority of
individuals diagnosed with IBS will need to have a colonoscopy and biopsy, but most scopes
look healthy/regular.
What is causing this disease to be so prevalent in our society nowadays? What causes
Irritable Bowel Syndrome to flare-up? To date, there is no identified direct cause to Irritable
Bowel Syndrome, but rather various factors that come together to produce a unique form of the
illness for each individual. The main pathophysiological factors of IBS are abnormal gut motility
and visceral hyperalgesia, but research is showing that some psychiatric factors can also
contribute to the illness.
Gut motility is altered in those with IBS. The small and large bowel can move at a slower
or faster rate compared to a normal healthy gut. Individuals who have IBS-D often react in a
more sensitive/timely matter to gut irritation as their digestion has been sped up. The gut reflexes
are abnormal in patients with IBS, possibly from secreted serotonin triggering reflexes which
affect peristalsis. Physical and immune stress have also been shown to negatively affect gut
motility.
Recent research has shown that the main reason for the induction of pain by the body in
patients with IBS is visceral hypersensitivity (internal organ pain heightened). Smaller amounts
of bloating can cause more pain than they would in an average person who does not experience

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visceral hypersensitivity. Digestion that would be routine and painless for an ordinary person can
be excruciating. This is a curious dilemma as those with IBS usually have normal or even
lessened sensitivity to somatic stimuli. There is a correlation between visceral hypersensitivity
and mood disorders such as Major Depression and Bipolar disorder. This is thought to be
because of the stress of pain and sensitivity that seems relentless and/or without real cause.
There is a definite correlation between psycho-emotional factors and gut motility. Anger
promotes increased contraction in the sigmoid-rectum area, this being the exact opposite with the
feeling of fear. Anxiety can cause diarrhea (rapid transit) and Depression can cause constipation
(delayed transit.)
Treatment is limited for Irritable Bowel Syndrome. It is not classified as an auto-immune
disease like some other GI illnesses, therefore it cannot be treated with immunosuppressants.
Most treatment is based on changing diet to avoid symptoms and pain relief for when the illness
has flared-up. IBS patients are recommended to supplement their diet with fiber, more water
intake, and probiotics. Caffeine, legumes, lactose, fructose, and FODMAPs should be limited or
avoided altogether. Relaxation therapy, or reducing stress and promoting a relaxing environment
and mind has previously been a large part of the treatment, but it has been shown to make little to
no change.
To conclude, Irritable Bowel Syndrome is an incredible taxing illness that wreaks havoc
on millions upon millions worldwide. It can cause emotional distress and physical discomfort.
Though there isnt a great amount known about the cause or extremely effective ways to treat the
illness, research is constantly being done and more is being learned at a daily rate. There is hope
for the IBS community yet.

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Sources Cited
Freeman, Katherine. "Irritable Bowel Syndrome." Irritable Bowel Syndrome. N.p., Aug. 2010.
Web. 29 Nov. 2016.
Karantanos, Theodoros, and Theofano Markoutsaki. "Current Insights in to the Pathophysiology
of Irritable Bowel Syndrome." Gut Pathogens. N.p., n.d. Web. 23 Nov. 2016.
Kirsch, Richard H., and Robbert Riddell. "Histopathological Alterations in Irritable Bowel
Syndrome." Nature.com. Macmillan Publishers, n.d. Web. 23 Nov. 2016.
Lehrer, Jenifer K., MD, and Gary R. Lichtenstein, MD. "Irritable Bowel Syndrome." Irritable
Bowel Syndrome: Practice Essentials, Background, Pathophysiology. Ed. BS Anand.
N.p., 10 Oct. 2016. Web. 23 Nov. 2016.
Shah, Dr Rajesh. "Irritable Bowel Syndrome: Pathology." Pathology of Irritable Bowel
Syndrome (IBS) by Dr Shah. N.p., n.d. Web. 23 Nov. 2016.
The Editors of Enclyclopedia Britannica. "Irritable Bowel Syndrome (IBS)." Encyclopedia
Britannica Online. Ed. The Editors of Enclyclopedia Britannica. Encyclopedia
Britannica, n.d. Web. 23 Nov. 2016.