Irritable Bowel Syndrome

What is irritable bowel syndrome?

"Irritable bowel syndrome" is a symptom of discomfort that lasts for several weeks and is related to the abdomen/intestine for the affected person and the therapists treating them. This includes ruling out an organic disease that could explain the symptoms. It is therefore a disease that manifests itself in a disturbed function of the intestine. The symptoms may therefore be accompanied by both constipation and diarrhoea, or an alternation of both. Flatulence and pain in the abdomen are also typical. Often there is also a considerable sensitivity to different foods, which are not classic allergies or intolerances (such as lactose or fructose intolerance). Although these functional disorders are benign, the quality of life of the affected people is often considerably restricted and significant alterations to their everyday lives have to be accepted.

Irritable bowel syndrome can be a direct dysfunction of intestinal activity that remains as a symptom for weeks or months, e.g. as a result of a viral or bacterial inflammation of the gastrointestinal tract. Chronic functional intestinal complaints can also be found without definable triggers. Furthermore, the classic complaints of irritable bowel syndrome can also be symptoms of psychosomatic and psychiatric conditions. Mixed pictures are not atypical. A good differentiation of the causes of the symptoms is essential for meaningful and promising therapy.

Accordingly, in addition to a detailed medical history and physical examination, a sensible physical exclusion diagnosis is initially carried out, which may include the following examination (always depending on the medical history and complaints): blood tests, stool examination, ultrasound of the abdomen, if necessary gastroscopy and colonoscopy (incl. sampling of the mucosa), testing for sugar intolerances and bacterial overgrowth in the small intestine. In individual cases, further diagnostic steps are necessary, such as a gynaecological co-assessment.

If the suspected diagnosis is confirmed, we pursue a multi-modal therapy approach in Havelhöhe, depending on the individual case and the most significant symptoms. This includes different therapy strategies. An important part is the anthroposophic medicinal approach. Here, for example, herbal bitter remedies such as gentian and absinthe, herbal anti-spasmodics such as copper and nicotiana, camomile and peppermint oil, as well as mucosa-stabilising mineral medicines such as stibium and siliceous substances are used. External applications (compresses, wraps, foot baths, etc.) may also be used. An important therapeutic approach is art therapy or movement therapy approaches (e.g. eurythmy therapy). Also of great importance is the conversation, which represents an independent therapy approach for the lifestyle-changing activities that are needed.

Since we, like all acute hospitals, are subject to tight financial conditions that often do not allow us the space and time to fully meet the above requirements, we try to initialise a therapy concept at least in the above sense, which can then be continued on an outpatient basis.

What are the causes of an irritable stomach?

Around 30 per cent of people suffer from occasional stomach complaints with nausea, a feeling of fullness or pain in the upper abdomen. If these symptoms recur frequently and the quality of life of those affected is restricted as a result, we speak of an irritable stomach (functional dyspepsia). This means that digestion is disturbed even though there is no organic disease of the stomach, such as a stomach ulcer. Often, symptoms of irritable bowel syndrome occur at the same time, with flatulence, cramps or diarrhoea.

The causes for the development of an irritable stomach can be manifold. Some patients have a very sensitive nervous system in the gastrointestinal tract, making the stomach hypersensitive to stimuli. Other causes can be functional complaints that remain as a result of primary organic diseases. Psychological stress such as worry, stress, too little sleep or stressful life events can also cause an irritable stomach.

What symptoms does an irritable stomach cause?

With an irritable stomach, patients suffer from various digestive symptoms. Most often, they complain of burning or dull pain in the upper abdomen and pressure in the stomach area. This is often accompanied by a feeling of fullness, acid regurgitation, loss of appetite or a quick feeling of satiety. Some sufferers also experience a sudden aversion to certain foods.

How is an irritable stomach diagnosed?

In order to ensure the diagnosis and to be able to exclude any serious organic disease, there is first a detailed discussion with the patient and a thorough physical examination. In addition to a blood test, an ultrasound examination (sonography) and a gastroscopy are also performed. A thin tube with a small camera is inserted into the stomach via the oesophagus to view the mucous membrane. If the patient also suffers from irritable bowel symptoms, a colonoscopy may also be necessary.

If an organic disease can be ruled out on the basis of the examination results, a significant improvement of the symptoms can often be achieved through targeted measures.

How is an irritable stomach treated?

Medications such as proton pump inhibitors or H2 antagonists can be prescribed for short-term relief of severe and prolonged symptoms. They reduce the production of stomach acid and thus prevent further irritation of the stomach. However, the use of these drugs should only be for a short period of time and only under medical supervision.

If a movement disorder of the stomach is the cause of the complaints, motility regulators or prokinetics can also be given. They stimulate the mobility of the digestive tract. The stomach contents are thus better transported through the digestive tract, so that feelings of fullness or nausea no longer occur.

In the long term, only a change in lifestyle often helps with an irritable stomach: changing eating and living habits, structuring daily rhythms, reducing stressful life factors, stress reduction and resilience training, etc. During inpatient treatment in Havelhöhe, patients therefore also receive tips for a balanced diet and, if needed and desired, offers of consultations from therapists and psychologists.

Patients also experience relief through external applications as a self-help strategy from anthroposophic care, such as moist warm compresses with clover (oxalis), yarrow, camomile or caraway, rubs or foot baths.