Irritable Bowel Syndrome (IBS) is a chronic disorder associated with prolonged psychological stress, which causes abdominal pain and also causes changes in bowel regulation.
Below we will explain in more detail what IBS is and then we will see what is known about its causes, ending with providing information on its treatment and some guidelines that can be included in the guide. daily routine of people in order to relieve them. its symptoms.
What is irritable bowel syndrome?
Irritable bowel syndrome is a disorder affects the functioning of the intestinal tract, therefore, it is considered to be a disorder of the gastrointestinal system and as such is known to be linked to physical and psychological factors associated with the stress that the person has suffered for a long time.
When researcher Hans Selye did his research on stress, developing what is called the stress theory, he discovered that the sympathetic nervous system innervates the stomach, which is why, as a result of this discovery, we now know that the activation of the NHS has an impact on this organ.
This relationship between IBS and stress is demonstrated because the brain is interconnected with the gut by nerve and hormonal signals. Therefore, these signals affect the functioning of the intestine.
So when the person suffers from prolonged stress over time, these nerve signals that the brain sends to the stomach are usually more active and intense, and this it can weaken the intestines, so the person has an upset stomach and bowel rhythms are misaligned, so you may end up suffering from diarrhea or constipation.
The causes of irritable bowel syndrome are unknown, but what is proven is that has a strong relationship with stress, because according to some research between 50-85% of patients diagnosed with IBS suffered from high levels of stress and it was also found in another study that these patients often had high levels of depression, neuroticism, anxiety and hypochondria.
The way IBS is explored and diagnosed is through observing the most common symptoms, which we will see later, and also through a medical examination in which the physical state of health is explored, in addition to achieving a blood test.
Irritable bowel syndrome develops chronically, but is not constantly present in the life of the patient, but occurs in the form of intermittent flare-ups; or what is the same, their symptoms go away completely, or to a large extent at times, and at other times when the patient is under a lot of stress or does not lead a healthy lifestyle, they may reappear. In addition, when the patient takes care of his habits, he can keep the symptoms of IBS away, so that they do not cause him so much discomfort.
There are also studies which have shown that when the symptoms have improved or are under control, this syndrome could be triggered again by various lifestyle factors such as alcohol consumption, caffeine, stress and l ingestion of certain foods such as chocolate, soft drinks, pastries. , as well as all ultra-processed foods high in sugars and saturated fat.
Symptoms of irritable bowel syndrome are the following:
- Abdominal pain; which usually comes back during bowel movements.
- Abdominal distended, and even in some cases can be swollen.
- Changes in biorhythms in relation to defecation. If you have diarrhea we will talk about IBS-D, while if you have constipation I would have IBS-E.
- Change in the appearance of stools; generally showing a poor appearance.
These symptoms usually appear in situations where the patient is experiencing more stress. and the overload of those who suffer normally.
It should also be noted that patients with IBS, in general, tend to be more concerned about their health and to rate their physical and psychological state more negatively than other patients. This is why the symptoms of hypochondria are very common.
It has even been identified that these patients have a very distinctive pattern of behavior known among healthcare professionals as “learned behavior from chronic disease” and this is characterized by an inordinate concern for the problems of his disease and, therefore, they go to the doctor very often.
Epidemiology of this syndrome
Irritable bowel syndrome it is the most common disorder among those that affect the proper functioning of the digestive tract, because its diagnosis ranges from 30 to 70% of patients who go for an outpatient visit to doctors specializing in the digestive system and about 25% of those who go to your GP for digestive problems or, which is the same, 1 on 4 people.
Among the general population, it has been estimated that between 10% and 25% may have symptoms compatible with irritable bowel syndrome, and of these, well less than half (25% to 40%) seek professional help.
According to epidemiological data from studies related to irritable bowel syndrome, this is a health problem that it can be up to two or even three times more common in women than in men.
Treatment of irritable bowel syndrome
According to the medical literature specializing in irritable bowel syndrome, there is currently no treatment that can completely eliminate the symptoms permanently or for a prolonged period of time.
As this disease cannot be completely eradicated, the main objective of its treatment is to improve the functionality of the subject because he can lead an active life and be as satisfying as possible and, given the high frequency with which these patients show symptoms of depression and anxiety, psychological treatment is of great importance.
The treatment which should be used the most to treat all the symptoms of these patients is multidisciplinary, combine medical monitoring with prescription medication to relieve symptoms and psychotherapy.
While it is true that there are specialized studies that have found evidence of greater effectiveness in the treatment of IBS in psychological treatment than in medical treatment, and more specifically it is multi-component cognitive therapy. which was able to demonstrate more empirical validity (Pérez et al., 2006). However, more research is still needed on psychological treatments for IBS.
On the other hand, psychological treatment is more expensive, which is why it is difficult today to use it widely in patients with IBS. Therefore, the most used treatment is the doctor, with outpatient consultations and the prescription of drugs.
1. Medical treatment
Medical treatment treats motor and sensory alterations in the physiology of the intestine, as well as possible intolerance to certain food groups (eg lactose, gluten, etc.).
However, there is no clear evidence that there is a single primary abnormality in the digestive tract in cases of IBS, but it could be a systemic disease, affecting various structures of the body.
As for the pharmacology used to relieve certain symptoms, we find prescription of antispasmodics in order to relieve the pain from which they suffer in some cases, it is combined with antidepressants; because they have anticholinergic effects which help in cases where the pain is more intense. There is some research which claims that the most useful would be the combination of drug use with psychological therapy.
Below we will do a brief review of some of the psychological techniques used to treat IBS.
2. Muscle relaxation
The aim of this technique is to relax the different muscle groups separately., so that the patient enters a state of relaxation as a measure to relieve or prevent symptoms of stress that cause symptoms of IBS to worsen.
The components of this technique are:
- Contract a muscle group for a few seconds, then relax.
- Concentrate on the sensations produced by the contraction and relaxation of each of the muscle groups.
It has been shown that, the more the muscle is contracted at the same time as the subject is concentrated in the sensations that this action produces, the greater the state of relaxation will be able to achieve.
Biofeedback is a technique often used in combination with relaxation, and what one aims to achieve by training both techniques is that the patient learns to voluntarily control certain physiological states of his body seeking to generate a state of relaxation.
And this is thanks to the fact that with the techniques of biofeedback, you can learn to be aware of the changes that are taking place in the condition of your body.
The most commonly used biofeedbacks to control stress through general patient relaxation are:
- Electromyographic: used to measure the muscle tension felt.
- Temperature: used to detect temperature as an indicator of blood flow.
- Electrodermal: used to detect changes in the action of the sweat glands.
- Breathing: It is used to check the rhythm and location of breathing.
The most used relaxation technique is mindfulness, with the aim of teaching the patient to focus his attention on the present moment and not to reinforce anxiety, without issuing a personal assessment of what he feels or perceives around him at that time.
This technique is based on a perspective that understands that thoughts cannot be controlled and that when people strive to try to control them, the only thing they get is that these thoughts cause them discomfort to take with them. more importance than they deserve and this causes them even more stress than what they suffered at the beginning.
In short, thanks to mindfulness it is intended to eradicate efforts to control internal events (negative thoughts and emotions) that people with stress and discomfort try to achieve. As can be the case for people with irritable bowel syndrome.
Lifestyle habits that improve the course of irritable bowel syndrome
There are habits that the patient can incorporate into their daily routine in order to lead a healthier lifestyle that may help keep IBS under control, relieving your symptoms. These habits are:
- Get enough sleep at night and maintain a stable sleep schedule so your biorhythms don’t go awry.
- Staying physically active, being able to exercise lightly (for example, walking at least 30 minutes a day).
- Eat foods high in fiber (for example, oats, lentils, vegetables and fruits).
- Friend, Me (2020). Manual of Health Psychology. Madrid: Ediciones Pirámide.
- APIR (2019). Manual of Health Psychology. Madrid: APIR.
- APIR (2019). Manual of psychological treatments. Madrid: APIR.
- Pérez, M., Fernández, JR, Fernández, C. I Amic, I. (2006). Guide to effective psychological treatments II. Madrid: Ediciones Pirámide.
- Roberts, A. (2020). The great book of the human body. Madrid: Editorial DK Spain.