The irritable bowel syndrome: Introduction

Introduction: The irritable bowel syndrome (IBS) is a disturbed state of intestinal motility for which no anatomical cause can be found. Other names are a.o., irritable colon, but the authors prefer the name IBS as the condition affects the small bowel as well. The disease is characterized by altered bowel function with or without chronical abdominal pain. Three clinical patterns: (1) spatic colon-abdominal pain and constipation; (2) painless diarrhea with mucus; (3) alternating diarrhea and constipation. Description of 2 case reports. Intestinal motility: In IBS abnormal motility is shown by physiological experiments and investigations. In spastic types there is hypermotility, in diarrhea motility is less or absent. Psychological and psychophysiological aspects: The authors' experience shows that there is a relationship between psychological stress factors and the onset and exacerbation of symptoms in the IBS. There is no relationship to a specific personality profile, psychiatric illness or a special set of stress factors. There is some relation between the psychological reaction upon psychological stress and the symptoms of IBS. Symptoms of constipation and pain and bowel hypermotility are associated with anger and an attitude of a coping style of behavior. Patients with diarrhea and decreased motility appear helpless and anxious. Treatment: A wise, tractful and understanding conduct of the doctor towards his patient is the best method of treatment. The doctor should help his patient to cope with his stress situations by sensible advice. Diet and medicines are not of much help.