Answer to Question 1
Although the causes of irritable bowel syndrome remain elusive, people with the disorder tend to have excessive colonic responses to meals, GI hormones, and psychological stress. Intestinal transit may be accelerated, leading to diarrhea, or be delayed, causing constipation. Many individuals exhibit hypersensitivity to a normal degree of intestinal distention and feel discomfort when experiencing normal meal transit or typical amounts of intestinal gas. Some patients show signs of low-grade intestinal inflammation; others may have had a bacterial infection that initiated their GI problems. Many patients have coexisting psychiatric disorders, such as anxiety and depression, which can exacerbate symptoms. Nutrition therapy aims to identify food intolerances that may worsen symptoms and help patients establish dietary patterns that ensure nutrient adequacy. The foods that aggravate symptoms vary considerably among patients, and tolerances are best determined by trial and error. Examples of problematic foods include gas-producing foods, wheat and other grains, milk products, caffeine-containing beverages, and carbonated beverages. Some individuals have less discomfort when they consume small, frequent meals instead of larger ones. Supplementation with psyllium (Metamucil or Fiberall) may help to improve constipation and, possibly, other symptoms.
Answer to Question 2
B