Irritable bowel syndrome not `all in the head`

Washington: A new study has argued that irritable bowel syndrome is not “all in the head,” as has been commonly thought.

In a review of the literature, Michael Camilleri, M.D., a Mayo Clinic gastroenterologist, dismisses the notion that symptoms are specific to a single cause, and says symptoms are indications of several disturbed motor and sensory processes.

Irritable bowel syndrome is common, affecting 10 to 20 percent of the population in developed countries. IBS is not a disease, but rather a group of symptoms that occur together. The most common symptoms are cramping, abdominal pain, bloating, gas, diarrhea and constipation.

“Our goal is a better understanding of the mechanisms behind this syndrome. That way, we can foster individualized, specific treatment for patients with IBS,” Dr. Camilleri said.

Why patients develop IBS is not clear. Psychological factors and genetic predisposition play a part in IBS, but Dr. Camilleri points to a variety of underlying irritants that disturb gastrointestinal functions and contribute to IBS symptoms.

Examples include digesting certain food, prior gastroenteritis, the patient’s gut flora, and bile acids and fatty acids (involved in digestion of food) arriving in the colon.

“If we can identify these irritants in the individual patient, we have the opportunity to prevent or reverse symptoms,” Dr. Camilleri stated.

The review appeared in the New England Journal of Medicine.