Irritable bowel syndrome (IBS): its types, symptoms, and behavioral and pharmacological treatment methods

Irritable bowel syndrome (IBS) is one of the most common health challenges facing modern societies, closely linked to fast-paced lifestyles and psychological stress. It is no longer viewed as a mere passing digestive disorder, but is now understood in the global medical community as a complex condition reflecting a disruption in communication between the brain and the digestive system, scientifically known as the "gut-brain axis." This modern understanding opens new avenues for diagnosis and treatment that extend beyond traditional medications to include behavioral and psychological approaches.

In this context, Dr. Yousef Al-Namrawi, a consultant in internal medicine, confirmed to Al-Youm newspaper that irritable bowel syndrome (IBS) is a chronic functional disorder, not an organic disease. It is characterized by recurrent abdominal pain and changes in bowel habits, without any visible abnormalities in the intestines upon physical examination. Although it is not classified as a life-threatening illness, its impact on the quality of life of those affected can be significant, necessitating a thorough understanding of the symptoms and how to manage them.

Types and classifications of irritable bowel syndrome

Dr. Al-Nimrawi pointed out that irritable bowel syndrome is divided into four main types based on the nature of the prevalent symptoms, which are:

• Type 1 (predominance of diarrhea): characterized by loose or watery stools with an increased frequency of bowel movements and a feeling of sudden urgency.
• Type 2 (predominance of constipation): characterized by hard stools, difficulty in defecation, and a feeling of incomplete emptying.
• The third type (mixed): Constipation and diarrhea alternate, and it is considered one of the most difficult types to control therapeutically.
• Type IV (unspecified): Symptoms appear irregularly and do not meet the full criteria of the previous types.

Diagnostic criteria and warning signs

The diagnosis of irritable bowel syndrome (IBS) is primarily based on medical history and clinical symptoms, specifically the presence of recurrent abdominal pain at least once a week for the past three months, accompanied by a change in stool consistency or frequency. Dr. Al-Nimrawi explained that laboratory tests are conducted to rule out other diseases, especially when "warning signs" are present.

The consultant warned against ignoring these signs, which require immediate medical attention, and include: blood in the stool, unexplained weight loss, anemia, fever, onset of symptoms after age 50, or a family history of organic colon diseases.

Treatment strategies: from food to behavior

Dr. Al-Nimrawi emphasized that successful treatment begins with reassuring the patient and explaining the nature of the disorder, while focusing on lifestyle modifications. This includes reducing caffeine intake, trying a low-FODMAP diet, and exercising regularly.

Regarding medication, it varies depending on the type of diarrhea; antispasmodics and anti-motility drugs are used for diarrhea, while fiber and laxatives are used for constipation. The crucial point highlighted, however, is the role of psychotherapy and behavioral therapy . Cognitive behavioral therapy (CBT) has proven highly effective in improving symptoms, particularly in patients with anxiety, thus underscoring the interactive nature of this disorder between psychological state and bowel function.