Colonoscopy
We recommend that patients undergo colonoscopy before starting medication. Endoscopy is recommended before making the diagnosis of IBS. Since abdominal symptoms may also originate from serious diseases of the lower gastrointestinal tract, such as colorectal cancer and chronic inflammation of the intestines (e.g. Crohn's disease), endoscopy can rule out the possibility of these serious diseases. If the test results are normal, patients will have a higher chance of developing IBS.
Type of IBS
According to the 2006 American Gastroenterology Society Rome III criteria, IBS can be divided into 4 types, and it may change over time.
- Diarrhoea(IBS-D): Most of the time, stool is mushy or even watery, but rarely too hard.
- Constipation(IBS-C): Most of the time, stool is too hard or too dry, but rarely mushy.
- Mixed(IBS-M): The stools are sometimes mushy; sometimes they are too hard. These two conditions may occur alternatively.
- Unclassified(IBS-U): Stools are generally normal, rarely too hard or mushy.
People with IBS may change their type over time. Study showed that 75% of patients changed their type within one year, and 30% of patients changed from diarrhoea to constipation or from constipation to diarrhoea within one year.
Treatment of IBS
The main purpose of treatment for IBS is to alleviate the symptoms and reduce the impact of abdominal discomfort on the patient's daily life, rather than curing the disease. In fact, the drugs currently prescribed are mainly for individual symptoms, such as when patients have abdominal pain and diarrhoea, doctors will prescribe anti-diarrheal drugs and so on. Therefore, patients with IBS may receive different prescriptions from their doctors.
Drugs for the treatment of IBS are mainly aimed at individual symptoms, which can be roughly divided into the following categories:
- Antispasmodic drugs: Reduce the contraction of the intestine, suitable for patients with abdominal pain or bowel cramps.
- Antidiarrheal: Slows down intestinal peristalsis and prevents diarrhoea. Suitable for patients who often have diarrhoea or need to go to the toilet frequently which affects their daily life.
- Laxative: Promotes intestinal peristalsis and makes stool easier to excrete, suitable for patients with constipation.
Patients can take medication as prescribed, or when symptoms show up. These drugs are more effective in preventing symptoms of IBS. However, for the treatment of sudden symptoms, the effect is less significant. If the patient needs to take other drugs for a long time or at the same time, he or she must follow the doctor's instructions and conduct follow-up consultations to monitor the condition.