Irritable bowel syndrome natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Overview
The symptoms of irritable bowel syndrome (IBS) usually develop in the second decade of life, and start with symptoms such as abdominal pain, diarrhea and constipation. IBS may develop after exposure to early life adverse events, sexual abuse, anxiety, depression and stressors. Psychological conditions may also develop as complications of the disease. If left untreated, patients with IBS may progress to develop malnutrition (resulting from food intolerance), impacted bowel, and poor quality of life. Common complications of IBS include dehydration, hemorrhoids and fatigue. Prognosis is good, as IBS does not lead to life threatening complications or shorten lifespan of an affected individual. IBS patients tend to have long symptom free intervals interspersed with periods of severe symptoms. Although Irritable bowel syndrome may be a life-long condition, symptoms can often be improved or relieved through treatment.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of IBS usually develop in the second decade of life, and start with symptoms such as abdominal pain, diarrhea and constipation.
- The symptoms of IBS typically develop after exposure to early life adverse events, sexual abuse, anxiety, depression and stressors. Psychological conditions may also develop as complications of the disease.[1][2][3][4]
- If left untreated, patients with IBS may progress to develop malnutrition (resulting from food intolerance), impacted bowel, and poor quality of life.[5][6][7][8][9][10]
Complications
Complications of irritable bowel syndrome may include:
- Dehydration in case of diarrhea predominant IBS leading to loss of water and electrolytes.[11]
- Impacted bowel [12]
- Hemorrhoids: Hemorrhoids are the most common lesions in IBS patients, found in 18-33 percent of cases.
- They are formed by swelling of veins of the lower rectum or anus due to low fiber in the diet, constipation or straining during defecation. [13] [14][15] [16][17]
- Depression and anxiety [1][2][3][4]
- Fatigue [18]
- Decline in quality of life: Quality of life (QOL) is a term that is used to describe a person’s daily living experience along with a chronic medical condition. [19][20]
- The effect on QOL is directly proportional to the severity of symptoms.
- Approximately 66% of people with IBS describe their symptoms as extremely disruptive as they interfere with activities of daily living (ADLs) and cause higher anxiety levels.[21][22]
- Patients are compelled to restrict their activities for approximately 20% of the year and this is more pronounced in IBS patients with diarrhea as compared to those with constipation.
- On an average, patients miss more than one day every other week or roughly eight days in a period of three months.
- The severity of symptoms in IBS patients directly affect employment.
- 30 percent of patients with severe symptoms are unable to work as compared to 5 percent of patients with mild symptoms.
- 13 percent of patients are jobless due to IBS. [5] [6][7]
- Malnutrition, resulting from food intolerance: Malnutrition due to absence of adequate caloric intake is extremely rare with IBS. However, malnutrition may occur with IBS patients, as dietary control is necessary to improve symptoms.[23]
- IBS patients avoid foods rich in fermentable oligo-, di-, monosaccharides and polyols (FODMAPs), which include rye, legumes, vegetables, wheat, fruits, which may lead to malnutrition.
- Patients may also adopt unhealthy diets in place of FODMAPs, which may lead to poor nutrition. [24]
Prognosis
- Prognosis is good, as IBS does not lead to life threatening complications or shorten lifespan of an individual.
- IBS patients tend to have long symptom free intervals interspersed with periods of severe symptoms.
- Irritable bowel syndrome may be a life-long condition, but symptoms can often be improved or relieved through treatment.
- Less than 5 percent of IBS patients develop another gastrointestinal disease.
References
- ↑ 1.0 1.1 Klem F, Wadhwa A, Prokop LJ, Sundt WJ, Farrugia G, Camilleri M, Singh S, Grover M (2017). "Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis". Gastroenterology. 152 (5): 1042–1054.e1. doi:10.1053/j.gastro.2016.12.039. PMID 28069350.
- ↑ 2.0 2.1 Hausteiner-Wiehle C, Henningsen P (2014). "Irritable bowel syndrome: relations with functional, mental, and somatoform disorders". World J. Gastroenterol. 20 (20): 6024–30. doi:10.3748/wjg.v20.i20.6024. PMC 4033442. PMID 24876725.
- ↑ 3.0 3.1 Fond G, Loundou A, Hamdani N, Boukouaci W, Dargel A, Oliveira J, Roger M, Tamouza R, Leboyer M, Boyer L (2014). "Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis". Eur Arch Psychiatry Clin Neurosci. 264 (8): 651–60. doi:10.1007/s00406-014-0502-z. PMID 24705634.
- ↑ 4.0 4.1 Csef H, Bornhauser N (2003). "[Psychosomatic aspects of chronic diarrhea]". MMW Fortschr Med (in German). 145 (50): 35–7. PMID 14963969.
- ↑ 5.0 5.1 Chakiath RJ, Siddall PJ, Kellow JE, Hush JM, Jones MP, Marcuzzi A, Wrigley PJ (2015). "Descending pain modulation in irritable bowel syndrome (IBS): a systematic review and meta-analysis". Syst Rev. 4: 175. doi:10.1186/s13643-015-0162-8. PMC 4674951. PMID 26652749.
- ↑ 6.0 6.1 Farndale R, Roberts L (2011). "Long-term impact of irritable bowel syndrome: a qualitative study". Prim Health Care Res Dev. 12 (1): 52–67. doi:10.1017/S1463423610000095. PMID 21426615.
- ↑ 7.0 7.1 Lea R, Whorwell PJ (2004). "Psychological influences on the irritable bowel syndrome". Minerva Med. 95 (5): 443–50. PMID 15467519.
- ↑ El-Serag HB, Pilgrim P, Schoenfeld P (2004). "Systemic review: Natural history of irritable bowel syndrome". Aliment. Pharmacol. Ther. 19 (8): 861–70. doi:10.1111/j.1365-2036.2004.01929.x. PMID 15080847.
- ↑ Olafsdottir LB, Gudjonsson H, Jonsdottir HH, Björnsson E, Thjodleifsson B (2012). "Natural history of irritable bowel syndrome in women and dysmenorrhea: a 10-year follow-up study". Gastroenterol Res Pract. 2012: 534204. doi:10.1155/2012/534204. PMC 3312222. PMID 22474441.
- ↑ Halder SL, Locke GR, Schleck CD, Zinsmeister AR, Melton LJ, Talley NJ (2007). "Natural history of functional gastrointestinal disorders: a 12-year longitudinal population-based study". Gastroenterology. 133 (3): 799–807. doi:10.1053/j.gastro.2007.06.010. PMID 17678917.
- ↑ Morley JE, Steinberg KE (2009). "Diarrhea in long-term care: a messy problem". J Am Med Dir Assoc. 10 (4): 213–7. doi:10.1016/j.jamda.2009.01.007. PMID 19426933.
- ↑ Mearin F, Ciriza C, Mínguez M, Rey E, Mascort JJ, Peña E, Cañones P, Júdez J (2016). "Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult". Rev Esp Enferm Dig. 108 (6): 332–63. doi:10.17235/reed.2016.4389/2016. PMID 27230827.
- ↑ "Definition & Facts of Hemorrhoids | NIDDK".
- ↑ Arora G, Mannalithara A, Mithal A, Triadafilopoulos G, Singh G (2012). "Concurrent conditions in patients with chronic constipation: a population-based study". PLoS ONE. 7 (10): e42910. doi:10.1371/journal.pone.0042910. PMC 3470567. PMID 23071488.
- ↑ Tan KY, Seow-Choen F (2007). "Fiber and colorectal diseases: separating fact from fiction". World J. Gastroenterol. 13 (31): 4161–7. PMC 4250613. PMID 17696243.
- ↑ Helvaci MR, Algin MC, Kaya H (2009). "Irritable bowel syndrome and chronic gastritis, hemorrhoid, urolithiasis". Eurasian J Med. 41 (3): 158–61. PMC 4261279. PMID 25610094.
- ↑ Peery AF, Sandler RS, Galanko JA, Bresalier RS, Figueiredo JC, Ahnen DJ, Barry EL, Baron JA (2015). "Risk Factors for Hemorrhoids on Screening Colonoscopy". PLoS ONE. 10 (9): e0139100. doi:10.1371/journal.pone.0139100. PMC 4583402. PMID 26406337.
- ↑ Han CJ, Yang GS (2016). "Fatigue in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis of Pooled Frequency and Severity of Fatigue". Asian Nurs Res (Korean Soc Nurs Sci). 10 (1): 1–10. doi:10.1016/j.anr.2016.01.003. PMID 27021828.
- ↑ Spiegel BM, Gralnek IM, Bolus R, Chang L, Dulai GS, Mayer EA, Naliboff B (2004). "Clinical determinants of health-related quality of life in patients with irritable bowel syndrome". Arch. Intern. Med. 164 (16): 1773–80. doi:10.1001/archinte.164.16.1773. PMID 15364671.
- ↑ Levy RL, Von Korff M, Whitehead WE, Stang P, Saunders K, Jhingran P, Barghout V, Feld AD (2001). "Costs of care for irritable bowel syndrome patients in a health maintenance organization". Am. J. Gastroenterol. 96 (11): 3122–9. doi:10.1111/j.1572-0241.2001.05258.x. PMID 11721759.
- ↑ Olgart LM, Edwall B, Gazelius B (1989). "Neurogenic mediators in control of pulpal blood flow". J Endod. 15 (9): 409–12. doi:10.1016/S0099-2399(89)80173-6. PMID 2700202.
- ↑ Canavan C, West J, Card T (2014). "The epidemiology of irritable bowel syndrome". Clin Epidemiol. 6: 71–80. doi:10.2147/CLEP.S40245. PMC 3921083. PMID 24523597.
- ↑ Briggs A, Yazdany S (1974). "Resistance of Bacillus spores to combined sporicidal treatments". J. Appl. Bacteriol. 37 (4): 623–31. PMID 4436161.
- ↑ Chey WD, Nojkov B, Rubenstein JH, Dobhan RR, Greenson JK, Cash BD (2010). "The yield of colonoscopy in patients with non-constipated irritable bowel syndrome: results from a prospective, controlled US trial". Am. J. Gastroenterol. 105 (4): 859–65. doi:10.1038/ajg.2010.55. PMC 2887227. PMID 20179696.