İrritabıl Bağırsak Sendromu (İBS)
Özet
İrritabil Bağırsak Sendromu (İBS), karın ağrısı, şişkinlik ve dışkılama alışkanlıklarındaki değişikliklerle seyreden, yaşam kalitesini ciddi oranda düşüren kronik ve fonksiyonel bir sindirim sistemi hastalığıdır. Dünya genelinde yaygınlığı %7 ile %21 arasında değişen bu rahatsızlık, ülkemizde %6,2-19,1 oranında görülmekte olup özellikle kadınlar ve düşük sosyoekonomik gruplarda daha sıktır. Tanı aşamasında Roma IV kriterleri baz alınarak son üç ayda haftada en az bir kez tekrarlayan karın ağrısı ve buna eşlik eden dışkılama bozuklukları aranırken, kanser veya inflamatuvar bağırsak hastalığı gibi organik nedenleri dışlamak için "alarm semptomlarının" sorgulanması kritiktir. Patogenezi; bozulmuş bağırsak motilitesi, visseral hipersensitivite, mikrobiyota değişiklikleri ve psikolojik faktörler gibi karmaşık bir yapıya dayanmaktadır. Tedavi süreci hastanın baskın semptomuna (kabızlık, ishal veya mikst tip) göre bireyselleştirilir; bu kapsamda düşük FODMAP diyeti ve lifli gıdalar gibi yaşam tarzı değişikliklerinin yanı sıra antispazmodikler, laksatifler, antidepresanlar ve bazen probiyotikler reçete edilir. Genellikle tekrarlayıcı bir seyir izleyen İBS yönetiminde, hastanın semptomlarını tetikleyen faktörlerin belirlenmesi ve etkili bir hekim-hasta iletişimi uzun vadeli başarı için hayati önem taşır.
Irritable Bowel Syndrome (IBS) is a chronic and functional digestive disorder characterized by abdominal pain, bloating, and changes in bowel habits, which significantly impairs quality of life. With a global prevalence ranging from 7% to 21%, the condition affects between 6.2% and 19.1% of the population in Turkey, being particularly more common among women and individuals of lower socioeconomic status. During the diagnostic phase, based on the Rome IV criteria, recurrent abdominal pain at least once a week for the last three months and accompanying defecation disorders are identified, while it is critical to investigate "alarm symptoms" to exclude organic causes such as cancer or inflammatory bowel disease. Its pathogenesis is based on a complex structure involving impaired gut motility, visceral hypersensitivity, microbiota changes, and psychological factors. The treatment process is individualized according to the patient's dominant symptom (constipation, diarrhea, or mixed type); in this context, lifestyle changes such as a low-FODMAP diet and fibrous foods are recommended, alongside prescriptions for antispasmodics, laxatives, antidepressants, and occasionally probiotics. In the management of IBS, which generally follows a recurrent course, identifying the factors that trigger the patient's symptoms and establishing effective physician-patient communication are vital for long-term success.
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