Possible Causes of IBS and Diagnosis

The most common symptoms of IBS include periodic bouts of abdominal pain accompanied by diarrhea, constipation, or both. Flatulence, belching, and bloating may also occur. The episodes may subside with a bowel movement. However, IBS patients may pass only a small amount of stool that may or may not contain mucus, and they may continue to feel an urgent need to defecate. IBS is often divided into two major variants:

1. Diarrhea-predominant IBS: three to seven bowel movements per day; loose, watery stools; and fecal urgency. One or more of these symptoms must be present.


2. Constipation-predominant IBS: fewer than three bowel movements per week; hard or lumpy stools; and straining during bowel movements. One of more of these symptoms must be present.

People with IBS appear to have hypersensitive nerves within the large intestine. Under certain conditions (such as stress or consumption of certain foods), the normal passage of stool and gas may cause pain. Research has suggested that IBS patients have extra sensitive pain receptors in the gastrointestinal tract, which may be related to an abnormal level of serotonin, a neurotransmitter involved in regulating digestion and mood. Their level of serotonin may help explain why people with IBS are likely to be anxious or depressed (Kasper DL et al 2005).

Other significant factors implicated in IBS include recent infection within the gastrointestinal (GI) tract, which can disturb the digestive flora necessary to help break down remaining nutrients in the colon (De Schryver AM et al 2000; Talley NJ et al 2002). Research has shown that in rare cases, IBS has developed following salmonella or Campylobacter pylori infections.

The diagnosis of IBS is a diagnosis of exclusion, meaning that all other possible diseases must be ruled out before a physician arrives at the diagnosis of IBS. Typically, the diagnosis begins with a medical history, including questions about the duration, severity, and characteristics of symptoms. The physician will ask about diet, stress, any medications currently being taken, and changes in bowel function. Most people with IBS have mild symptoms.

Laboratory tests, including complete blood count, thyroid function, erythrocyte sedimentation rate, and urinalysis, may be done to rule out other potential causes. Depending on symptoms, additional testing may include a lactose tolerance test and a check for the presence of blood, bacteria, and parasites in feces (NIDDK 2006).

The colon may be examined with flexible sigmoidoscopy or colonoscopy (procedure used to see inside the colon and rectum to screen for colon cancer as well) . If indicated, a biopsy from the colon can be performed. A colonoscopy is indicated when an individual is anemic or has lost weight or if polyps are found. However, in IBS the large intestine appears normal (NIDDK 2006; Lindor KD et al 2005).

A diagnosis of IBS may be made if patients have had abdominal pain or discomfort for at least 12 weeks, not necessarily consecutively, during the past year and if:

• The onset of pain corresponds to a change in the regularity of bowel movements


• The passage of stool relieves the pain


• The onset of pain corresponds to a change in the appearance of stool

Dietary recommendations include:

L-glutamine. L-glutamine is the most common amino acid in the blood and is important in maintaining strength and boosting the immune system. Under normal circumstances, dietary intake and production of L-glutamine are sufficient. However, in times of stress or increased energy output, tissues need more L-glutamine than usual. A lack can lead to improper absorption of nutrients and a depressed immune system (Roth E et al 1996; van der Hulst RR et al 1996). Nutrition and intestinal function are intimately related; consequently, chronic GI diseases such as IBS often result in malnutrition. Glutamine has protective and reparative effects on the colon and bowel (Ziegler TR et al 2000).

Aloe mucilaginous polysaccharides (AMP). Aloe mucilaginous polysaccharides are long chain sugar molecules composed of individual mannose and glucose sugar molecules connected together. The AMP molecule is but one of the approximate 200 ingredients found in the Aloe vera plant. However, the mucilaginous polysaccharide is the sole ingredient responsible for all the healing properties attributed to Aloe. Reduces inflammation which is involved in such diseases as ulcerative colitis, IBS and other gastrointestinal disorders.