A Review of IBS

I've found a very good new article which looks at the current diagnosis and treatment of IBS, as well as the latest theories on its causes. Written by the splendidly-named Dr Amy Foxx-Orenstein, who works for the prestigious Mayo Clinic in the US, it's a very good intro to some of the latest research on IBS, and well worth a read.

I've chosen a few bits to briefly comment on...

IBS - a complex, multifaceted condition...

Yep, it's not just a bit of bloating caused by stress, you know. So there.

Patients with IBS typically score lower than population norms or those with other chronic GI and non-GI disorders on measures of quality of life.

This is interesting, and it shows just how badly an IBS sufferer's life can be affected by their condition. In fact, two 'quality of life' studies showed that IBS has a greater impact on an individual's work life, social life and general ability to live normally than arthritis, diabetes or asthma. Tell that to the next person who calls you workshy.

IBS was long considered a 'diagnosis of exclusion', leading to excessive testing of patients...Fortunately, advances in research have led to the development of symptom-based approaches...and the development of consensus guidelines advocating a positive diagnosis of IBS based primarily on the pattern and nature of symptoms, without the need for excessive laboratory testing.

The idea of how many tests are actually necessary seems to vary a great deal. Some sufferers have colonoscopies, endoscopies, blood tests, stool samples and more before they are told they have IBS. Other people, like myself, have very minimal testing, if any. This review certainly backs a 'symptom-based' or 'positive' approach to diagnosing IBS, which means less tests and more observation of symptoms, which is good news for all those people who don't like having cameras stuffed up their bottoms.

This is not to say that all tests can be forgotten about, just that there's no need to test a patient for every other GI problem under the sun before sighing in defeat and labelling them with IBS - the traditional and, if I may so say, rather dumb IBS 'diagnosis of exclusion'.

Historically IBS was...viewed as a purely psychosomatic condition.

Yeah, tell me about it. And leeches were viewed as a cure for practically everything, so at least the little docs are making progress.

Although a patient's psychological state may influence the way in which he or she presents, copes with illness, and responds to treatment, no evidence supports the theory that psychological disturbances are the cause of IBS.

I'll just say that again - no evidence supports the theory that psychological disturbances are the cause of IBS. You see! The docs finally got their enormous brains out of their backsides. Well done.

Actually I should probably stop there, I'm making fun of what is a very good article. The good doc goes on to look at issues such as genetic factors in IBS (no conclusive evidence of a genetic link), post-infectious IBS, the role of serotonin, and the latest medications for IBS. Basically it's a "where we are now" article, and definitely required reading for anyone who still believes that IBS is a simple disorder caused by stress or unhealthy eating.