Although the disease often lasts for months or years and seriously affects overall well-being, life expectancy is not limited.
The transport of food in the large intestine (colon) is particularly disturbed. However, the entire digestive tract, including the small intestine and stomach, can be affected. Many people suffer from irritable bowel syndrome. Some present constant symptoms, while most occur only occasionally and in special situations. Irritable bowel syndrome usually first appears between the ages of 20 and 40. In Germany, one in five people becomes ill (even one in two patients with gastrointestinal problems). Women are affected two to three times more often than men.
It is assumed that a large proportion of irritable bowel symptoms are caused by a mobility disorder (motility disorder) of the intestinal muscles. The disturbed transmission of stimuli in the intestine is controlled and influenced by certain substances.
Individual symptoms of irritable bowel are not very characteristic, but in general they are almost typical of the clinical picture. The main symptoms are a constant alternation of abdominal pain and cramps, irregular stools, flatulence and a feeling that the stomach is very distended and tense. The pain can occur in various locations throughout the abdomen and is often difficult to localize. Defecation itself is often painful and many patients have the feeling that their intestines have not been completely emptied after a bowel movement. Abdominal pain usually improves after a bowel movement. Constipation and diarrhea occur alternately and there is often mucus in the stool. In addition to these intestinal problems, so-called extraintestinal symptoms may occur, such as headaches, back pain, fatigue, sleep disorders, anxiety and depression disorders, urinary disorders, menstrual or heart problems – all without an explainable physical cause. Most affected people do not experience symptoms at night. Symptoms are not life-threatening but often have a significant impact on quality of life.
The doctor first gets an idea of the symptoms through a detailed conversation (history) and a complete physical examination. A long course of the disease is typical of irritable bowel syndrome, as most of those affected only seek medical help very late and often after a long period of suffering. To rule out other diseases (for example, a malignant intestinal tumor or chronic inflammatory bowel disease) as the cause of the symptoms, additional tests may be helpful. Blood is taken (determination of blood count, signs of inflammation, liver and kidney values, etc.), urine and feces are examined. If necessary, ultrasound examinations of the abdomen, colon and/or gastroscopy, X-ray examinations, food intolerance tests and other examinations can also be performed. It is helpful for those affected to keep a diary of the time, duration and intensity of symptoms.
As the exact cause of irritable bowel syndrome is not yet known, treatment is especially aimed at relieving the various symptoms. Treatment includes dietary recommendations, medication and psychotherapeutic treatment. Whether and which medication is administered depends entirely on the symptoms presented by the patient. A permanent cure is currently not possible, but the pharmaceutical industry is working hard to find new active ingredients to alleviate the symptoms of irritable bowel syndrome and to cure the cause of irritable bowel syndrome.
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