IBS, which is usually classified as a functional gastrointestinal disorder, refers to a chronic disorder that affects the large intestine (colon). It affects the colon’s normal functioning and creates discomfort and pain, gas and bloating, diarrhea, or constipation (Ng et al., 2018). This condition affects approximately 15% of adults in the U.S. (Ng et al., 2018).
Causes
There is no exact cause for IBS. However, there are various factors that appear to cause IBS. Evidence shows that about 40 to 60% of patients diagnosed with IBS report psychiatric symptoms such as anxiety, depression, or somatization (Ng et al., 2018). These issues affect coping strategies and illness-associated behaviors. Besides, patients with a history of sexual, physical, or emotional abuse experience symptom severity. Stress tends to interfere with gastrointestinal function.
Additionally, the inflammation of the enteric mucosa is associated with symptoms. Patients with IBS often have infectious enteritis in the presence of hypochondriasis and stressful events. Other causes include changes in gut microbes and problems with the nervous system.
Risk Factors
- Stress
- Being young
- Being female
- Family history of IBS
- Infection or inflammation of the gut
Diagnostic Tests
The most effective diagnosis of IBS starts with a comprehensive patient history and physical examination. Some alarm symptoms may include anemia, being older than 50 years of age, unexplained weight loss, and gastrointestinal bleeding. Besides, the first evaluation should also be inclusive of a chemistry panel, complete blood count, and erythrocyte sedimentation rate, as well as a stool test for fecal occult blood. For patients over 50 years of age, performing a colonoscopy is essential to detect organic disease. Moreover, the thyroid-stimulating hormone should be measured (Camilleri, 2021).
Assessment Findings
After all other conditions have been ruled out, the physician will likely utilize certain diagnostic criteria for IBS. This may include belly pain and discomfort occurring at least once a week in the last three months. The pain and discomfort should be related to defecation, an alteration in stool consistency, and an alteration in the defecation frequency.
Besides, the abdomen may appear swollen with gas in the intestines. It may also be tender when the physician presses it. In addition, abnormal sounds may be heard, especially if the patient has diarrhea. The patient may report having increased constipation or diarrhea or an alteration of constipation with diarrhea. There may also be changes in bowel habits, such as stool having a lot of mucus, diarrhea, and constipation (Vich Vila et al., 2018).
Symptoms
The symptoms of IBS may be inclusive of abdominal pain and cramps, bloating, indigestion, and different symptoms of defecation. There are three main IBS sub-categories based on the principal symptoms. These symptoms are linked to constipation and pain and diarrhea alternating with constipation. Each patient exhibits unique symptoms such that while some patients experience IBS as an occasional nuisance, some may go through intense pain that adversely affects the quality of their life.
Multidimensional Nursing Care Interventions
Nurses should provide patient education by offering a clear and concise explanation of the disease’s pathophysiology, its causes and symptoms, and the influence of psychosocial factors. Patient education boosts self-management, and patients experience reduced symptom intensity and fewer return visits.
Nurses should also promote optimal nutrition, especially by encouraging patients to include fiber in their diets. Fiber is useful in stretching the bowel and reducing tension (Camilleri, 2021). Besides, some fiber supplements can help in relieving constipation and improving diarrhea symptoms. Nurses should also help patients create a daily food diary to determine the food trends and stress triggers.
Nurses should also perform an inventory of psychological distress, including the presence of certain personality features, anxiety or depressive disorder, worry, social stresses, and the inability to cope properly. Based on this analysis, the patient should be referred to a psychiatrist to reduce the intensity of IBS symptoms. Drug therapy, such as administering psychotropic agents and antidiarrheal agents, as well as alternative therapy, may also be used to manage the symptoms of IBS (Camilleri, 2021).
References
Camilleri, M. (2021). Diagnosis and treatment of irritable bowel syndrome: a review. Jama, 325(9), 865-877.
Ng, Q. X., Soh, A. Y. S., Loke, W., Lim, D. Y., & Yeo, W. S. (2018). The role of inflammation in irritable bowel syndrome (IBS). Journal of inflammation research, 11, 345.
Vich Vila, A., Imhann, F., Collij, V., Jankipersadsing, S. A., Gurry, T., Mujagic, Z., … & Weersma, R. K. (2018). Gut microbiota composition and functional changes in inflammatory bowel disease and irritable bowel syndrome. Science translational medicine, 10(472), eaap8914.
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