IBS, Irritable Bowel Syndrome is Not an Organic Disease

From the Communication Between the Brain and the Gut to Functional Rhythm Disorders: Understanding IBS

In surgery, the human body can be thought of as a high-speed, two-way highway. The Vagus nerve, the tenth of the 12 cranial nerves, is precisely this highway. While stimuli from the intestines travel to the brain via the Vagus nerve, all stimuli from the brain bring instructions to the intestines through the same pathway, and this order functions rhythmically. The reason I am explaining this mechanism is Irritable Bowel Syndrome, also known as IBS or the Disordered Bowel Syndrome, which is frequently encountered but difficult to diagnose.

To understand what Irritable Bowel Syndrome is, one must look at the clinical picture. There are patients who present to emergency services with severe abdominal pain. When these patients are examined, no organic findings may be detected; there may be no hardness, swelling, or fever in the abdomen. However, the patient's complaints are extensive. There are many symptoms such as pain, severe bloating, diarrhea, or constipation that has lasted for days. In other words, there are no apparent physical findings, but the unseen complaints are incredibly numerous.

There is no definitive gold standard diagnostic method, laboratory finding, or imaging for Irritable Bowel Syndrome. In a patient presenting with abdominal pain, a physical examination is performed first, and if no swelling, guarding, or fever is observed, further investigations are carried out. Initially, the condition of the organs is checked with an ultrasound, and if that is insufficient, blood tests are performed. Due to the abundance of complaints, colonoscopy and gastroscopy may also be performed. If no problem is found as a result of all these investigations, then an IBS diagnosis can be made.

This syndrome is not an organic disease and does not involve any somatic changes. From a surgical perspective, even if the abdomen is opened, the intestines are observed to move peristaltically, soft in the hand, moist, and regular. In such a patient, there is no diverticulum, tumor, stone, or any obstruction. Therefore, IBS is a diagnosis made when, after all possible organic problems have been ruled out, nothing remains.

This condition, generally seen in women and sometimes in men, is a disorder of the motor system, even though it is not an organic problem. It can be observed more frequently in individuals with high sympathetic activity, who are sensitive, responsible, and approach life with sensitivity. At this point, a second system that controls the intestines, the splanchnic nerves originating from the spinal cord, comes into play. Thoughts, responsibilities, and sensitivities in the brain can advance to this area and increase or disrupt bowel movements. Due to a person's psychological identity and their way of perceiving life, the rhythmic movement of the intestines changes without an organic problem. If the pain threshold is low, severe pain, gas cramps, diarrhea, or constipation attacks can be experienced.

One of the causes of the disease can also be sensitivity to foods. Therefore, it may be necessary to pay attention to food intolerances such as lactose intolerance and galactose intolerance, and to check for sensitivity to certain foods. The unseen pains and aches experienced, despite all controls being performed and no obstruction or organic lesion being found, can cause more distress than visible problems. Just as unseen pains in life, unnoticed emotional or social relationships, and social pressures can accumulate and lead to behavioral problems, functional rhythm disorders can arise in the intestines.

The treatment process is generally approached in long stages. First, attention to diet is recommended after checking for food intolerance. Since there are complaints of pain and problems, antispasmodics for smooth muscles may be used; drugs used for skeletal muscles may not be effective here. Additionally, drug groups that help regulate the rhythm of intestinal movements can be beneficial.

One of the most important points is that this disease can be related to a person's sensitivity, emotionality, and outlook on life. Therefore, the use of certain drug groups known as central SSRs, which balance the central nervous system, may be considered with psychiatric support. This approach can provide significant relief.

In conclusion, Irritable Bowel Syndrome is not a somatic disease requiring surgery, but a disorder of the working rhythm, a functional condition. Like the flow of life; if one runs too fast, they get tired; if they stop, they get blocked. However, if one remains balanced and establishes a healthy, balanced relationship with their surroundings and themselves, the complaints related to this syndrome can be observed to subside.