Closer Horizons For Irritable Bowel Syndrome

Irritable Bowel Syndrome or IBS represents a host of symptoms no longer limited to the small or large intestine. Its manifestations have included every segment of the gastrointestinal tract from mouth to anus, covering a multitude of complaints such as abdominal pain, nausea, heartburn, bloating, gas, distention, diarrhea, constipation and many others. They are known now as Non Cardiac Chest pain, NERD (Non Erosive Reflux Disease), Non Ulcer Dyspepsia, mimicking peptic ulcer disease, Dysmotility or reflux, Functional Bilio Pancreatic disease, Functional Colo-Rectal, Functional Small or Large Bowel disease. These symptoms did not correlate with any concrete finding following investigation with commonly used procedures namely endoscopy or radiology As a result the patient use to be considered neurotic or malingering for some obscure reason.

This syndrome became so frequent and so utterly misdiagnosed that it taxed the health care system with over $30 billions dollars a year. This triggered three international meetings of experts in Rome with the ensuing Rome Criteria I, II, and III. These criteria tried to define more specifically the time and intensity of the most frequently reported complaints, attempting to reach a universal consensus about such an elusive disease. In the last twenty years, many researches have been conducted nationally and all over the world trying to find a common denominator to all these ailments. Many diets were studied, eliminated and re-introduced, many possible intolerances (lactose, fructose), sensitivities or allergies were considered, many disease correlations were explored (Coeliac), and many therapies were attempted without always convincing results.

Several factors have been identified in the last few years as contributors to the syndrome of irritable bowel. All these following conditions have been responsible in numerous studies, and in various severity for the recurrent patients complaints, namely Dysmotility, Hypersensitivity with widening of the intercellular spaces in the epithelial layers, Brain – Gut Syndrome, Molecular factors, Genetic predisposition, Enteric infection, Food intolerance and
Socio – environmental situations. Other conditions may very well emerge to replace or complement the previous ones.

More recently, diagnostic modalities became of extreme importance. Nuclear gastric emptying studies, Electrogastrography, Real time ultrasound, capsule endoscopy, the Sitzmark Tablets, breath test, colonography and the Smartpill have given us invaluable information about the mechanics of this syndrome. Many investigators and now clinicians are within reach of a precise and definitive diagnosis with impactful therapy and long term relief of the patient’s symptoms.

At St. Luke’s Roosevelt Hospital Center we have the talents and the necessary tools to make effective clinical diagnoses and to help those with irritable bowel syndrome to better understand their condition and to achieve a clear relief of their symptoms.


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