Irritable Bowel Syndrome: Strategies for Managing a Complex Condition
]]>Irritable bowel syndrome]]> (IBS) does not easily fit into the traditional medical model. Researchers have not yet come up with a coherent scientific explanation, let alone a cause, for its debilitating symptoms. This means that there is no cure or even a comprehensive treatment. Doctors can offer a way to manage symptoms, though.
A Common Diagnosis
Doctors diagnose IBS in women more often than in men. The main symptoms are abdominal pain, usually associated with bloating and gas, and a change in bowel movements ( ]]>diarrhea]]> , ]]>constipation]]> , or alternating bouts of each). Mucus may be present with diarrhea, but there is no blood or pus.
Because tests show no abnormalities, doctors usually diagnose IBS only after ruling out similar diseases. Doctors suspect IBS when a person experiences abdominal pain with at least two of the following features:
- Pain is relieved after a bowel movement
- The onset of pain is associated with diarrhea or constipation
- The onset of pain is associated with a change in the form of the stool (loose, watery, or pellet-like)
Since IBS primarily affects the GI tract, diet is a good place to start. Many people benefit from avoiding certain foods and ingredients, such as:
- Fatty foods
- Gas-producing vegetables
For those who find a connection between their symptoms and what they eat, avoiding those foods can be effective.
]]> Fiber]]> may improve the colon's function and reduce symptoms, especially in people who tend to be constipated. Scientific research suggests that 20-30 grams of fiber per day is optimal. Good sources of fiber include:
- Whole grains, fruits, vegetables, and legumes
- Raw bran
- Psyllium seeds
Of the many herbs and supplements that have been recommended for IBS, ]]>peppermint]]> oil is one of the few backed by some scientific evidence. The recommended dose is 0.2 milliliter (ml) capsules three times daily after meals. Be sure to take the enteric-coated form, so that the capsule will not be broken down in the stomach before it reaches the intestines. Talk to your doctor before taking any herbs and supplements. They could affect medicines that you are taking or conditions that you have.
Stress management and exercise may be able to ease IBS symptoms. Some treatments that may be used to decrease stress include:
- ]]>Relaxation response]]> —the use of medicine and similar techniques to soothe the response to stress
- ]]>Biofeedback]]> —the use of computers and probes to dampen the physiologic manifestations of stress
- ]]>Cognitive-behavioral therapy]]> —teaching people to reframe the way they perceive pain and to modify their maladaptive responses
Regular aerobic exercise may help to mitigate stress and help normalize the muscular activity of the intestines. This may be particularly helpful for people with constipation.
Anther important part of treatment is becoming educated about IBS and ways to reduce the symptoms. Joining a ]]>support group]]> may also be a good way to learn about the condition and to share your experiences with others.
In addition to lifestyle changes, there are a number of medicines that may be helpful in treating the individual symptoms of IBS. In some cases, these medicines may be used in combination. Examples include:
- Antispasmodic agent (eg, ]]>dicyclomine]]>, alverine citrate)
- Antiflatulant (eg, ]]>simethicone]]>)
- Antidiarrheal agent (eg, ]]>loperamide]]> )
- Low-dose antidepressant
- Probiotics (eg, acidophilus)
- Pain reliever (eg, ]]>acetaminophen]]> )—may help with crampy abdominal pain
- Serotonin receptor agonists and antagonists (also called 5-HT3 antagonists)—may be helpful for treating diarrhea, as well as treating other IBS symptoms, like abdominal pain in women (eg, ]]>alosetron]]> )
These medicines, while often helpful, are no substitute for a comprehensive lifestyle approach. By finding effective ways to manage stress, exercise regularly, and modify your diet you can attempt to address the complex underlying causes of IBS.
Irritable Bowel Syndrome Self Help and Support Group
National Center for Complementary and Alternative Medicine
The Canadian Association of Gastroenterology
Irritable bowel syndrome. Net Doctor website. Available at: http://www.netdoctor.co.uk/diseases/facts/irritablecolon.htm. Updated September 2007. Accessed January 11, 2010.
Irritable bowel syndrome (IBS). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 2010. Accessed April 28, 2010.
Peppermint. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=114. Updated February 2010. Accessed April 29, 2010.
Wood D. Irritable bowel syndrome. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated January 2010. Accessed April 29, 2010.
4/30/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein AE, Brandt LJ, Quigley EM. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010;59(3):325-32.
7/16/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Dorn SD. Systematic review: self-management support interventions for irritable bowel syndrome. Aliment Pharmacol Ther. 2010 May 22. [Epub ahead of print]
Last reviewed May 2010 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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