What is IBS?
IBS stands for irritable bowel syndrome, and it is a condition that is actually manifested mainly by symptoms. Patients predominantly have pain associated with a change in their bowel habits. The bowel function change could either be diarrhea or constipation or, in some cases, both. We're starting to realize, with the discovery of serotonin receptors in the gastrointestinal tract, that serotonin probably plays an important role in IBS symptoms.
Could you describe some obstacles in receiving treatment for IBS?
In the United States, people are often uncomfortable talking about diarrhea or constipation. I think this reluctance most often affects IBS diagnosis and management in the primary care doctor's office. Primary care doctors usually don't have a lot of time, so if the patient is reluctant or unable to complain about their symptoms, they are not going to be addressed. Gastroenterologists tend to look closely at abdominal symptoms, so we'll take a more extensive history, focusing on symptoms of constipation, diarrhea and pain.
What are the main goals in managing IBS?
The main goals are to eliminate the symptoms as completely as possible. But even more important, the goal is to eliminate the anxiety that's surrounding the symptoms. Most patients are fairly anxious about their symptoms, so assuring them that this is not a life-threatening disorder will sometimes ease symptoms that may be magnified by their anxiety.
There are a number of factors that influence the success of therapy. I think one of the biggest obstacles to effective treatment is patients' expectations. Motility, or motor function, of the intestine in patients with IBS is not normal, so these patients may never have normal bowel habits.
