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The gastrointestinal tract contains a network of nerves. A chemical neurotransmitter known as serotonin regulates the movement and sensitivity of the bowel. Abnormalities in serotonin levels relate to the irritable bowel syndrome. Abnormalities in serotonin levels also relate to depression, just as IBS.
IBS is rarely debilitating, but in some cases, it can restrict the ability to attend school or social functions. It could also impair a patient’s work, or even travel short distances. IBS has many names including colitis, mucous colitis, spastic colon, spastic bowel, and functional bowel disease, all referring to the same problem. Some of these terms are inaccurate; colitis for instance, means inflammation of the large intestine. IBS, however, does not cause inflammation. That is why this condition should not be confused with ulcerative colitis. There is no evidence that IBS leads to more serious medical problems such as colitis or cancer. Irritable bowel syndrome also does not affect life span in any way. However, if left untreated, the symptoms will often persist, leading to ongoing pain and discomfort.
Diagnosing IBS
To be diagnosed with irritable bowel syndrome, the patient must have had 3 months or more of abdominal discomfort or pain. If this pain is relieved by defecation, or associated with a change in stool frequency or constipation, diagnosis might be IBS. If you have two or more of the symptoms 25% or more of the time (a change in stool frequency or form, altered stool passage, mucus in the stool or bloating), your diagnosis may be IBS.
Treatment of IBS
Lotronex or alosetron is now FDA-approved for the treatment of IBS for patients with moderate to severe diarrhea as their predominant symptom. This medication was pulled from the market due to severe adverse reactions. Ischemic colitis occurred in a few patients with constipation-predominant IBS. Each doctor who prescribes Lotronex must participate in a special program aimed to avoid this complication.
Doctors were approving Zelnorm or tegaserod maleate in July 2002 for the treatment of IBS in those whose primary symptom is constipation. The major side effect is diarrhea, usually during the first week of treatment.
Celexa or citalopram is an antidepressant in the SSRI (selective serotonin reuptake inhibitor) class. This may help women with IBS who are constipated, anxious, and who have difficulty sleeping, but side effects may include weight gain and decreased libido.