Aggravating and relieving factors in irritable bowel syndrome

Abstract

Irritable bowel syndrome is a very common gastroenterological problem encountered in clinical practice. Various factors are known to either aggravate or relieve symptoms of this condition. In this prospective study, effects of various factors eg. food, liquor, time of the day, stress, on three main symptoms of irritable bowel syndrome (IBS) viz, abdominal pain, abdominal distension and altered bowel habit -have been assessed. Ninety two consecutive patients diagnosed as having IBS at the University Medical unit of the General Hospital. Colombo between March 1980 and April 1981 were admitted to this study. Effects of various factors were studied by direct interrogation of patients with the help of a questionnaire. Conclusions: Food in general aggravated abdominal pain (in 76%) abdominal distension (in 73%) and diarrhea (in 77%) in the majority of patients and milk (in 55% of patients) were the worst offenders. Abdominal pain (in 40%) abdominal distension (in 30%) and diarrhea (in 31%)were worse in the morning in a significant proportion. Abdominal pain and distension were worse in the evening in 30%and 34% of patients respectively. Symptoms were worse in the night only in a very small number of patients. Stress did not seem to be an important aggravating factor as it made the symptoms worse only in a minority. (abdominal pain, abdominal distension and diarrhea in 10%,11% and 13% of patients respectively. Abdominal pain (in 60%)and abdominal distension (in 38%)were worse during the diarrhoeal phase, but constipation did not have such a significant effect. Defaecation and passage of flatus were the only significant relieving factors and these two relieved abdominal pain (in 85% and 81% respectively) and abdominal distention (in 72% and 74 % respectively) in the majority of patients. None of the factors studied, affected constipation significantly.