Return To Main Article
|How Is IBS Treated?
As there are different causes of irritable bowel syndrome (IBS) there is no one treatment which suits all. For some people, obtaining an IBS diagnosis and thereby ruling out any underlying serious illness can be enough to reduce stress and alleviate the problem. However, for most people, treatment requires dietary and lifestyle changes and occasionally medications. IBS is not 'cured' but rather managed. The focus is to relieve discomfort and adjust bowel habits. Almost 70 percent of people with IBS are not receiving treatment for their condition. This may be because their symptoms are mild, or else they know there is no specific cure so question the benefit of a doctor's involvement. Yet, doctors are able to offer useful advice specific to the patient's symptoms.
Generally speaking doctors advise people with IBS to eat a high fiber, low fat diet and to avoid foods which cause excess gas. This is known as an IBS diet plan (see our Free IBS recipes). It is worth keeping an IBS food diary, noting when symptoms occur as this will help identify any specific trigger foods or drinks.
Foods To Avoid
• Foods which can cause gas and bloating are beans, bananas, carbonated drinks, onions, celery, carrots, apricots, cabbage, broccoli and cauliflower.
• Drinks which stimulate the intestines - namely those that contain caffeine like coffee, sodas and tea.
• Refined carbs as they tend to be high in gluten. This means avoiding any products with wheat, oats, barley and rye. Instead choose gluten free products. These may be labeled 'suitable for celiac's’.
• All dairy produce including milk, yogurt, cheese, chocolate and ice cream. Dairy can be a trigger, even in those who are not lactose intolerant.
• Soya can cause problems for some people.
• Other possible triggers include citrus fruits, especially oranges.
• Foods containing tyramine like port, red wine, cheese, beef, herring, liver and sauerkraut.
• Melted cheese dips, it is impossible for the gut to digest!
• Monosodium glutamate (MSG) can cause IBS symptoms and may cause migraines.
Foods To Include
• Foods high in fiber include figs, dates, prunes, and raisins.
• Organic rice or almond milk.
• Spice food with fresh ginger, it soothes the intestines and has anti-parasite properties. Pumpkin seeds have the same effect.
• Eat pineapple between meals; it contains bromelain which helps aid digestion.
• Start drinking more herbal teas like peppermint, rosemary, chamomile and fennel, all of which aid digestion.
For those suffering constipation, a bulk forming laxative such as psyllium may be recommended. Stronger laxatives may be prescribed but regular use can lead to dependence and eventually make constipation worse. For women with IBS related constipation, the FDA has recently approved a serotonin-active drug called tegaserod (brand name Zelnorm). Our guide to diarrhea explains the various antidiarrheal medications and supplements available. Doctors often recommend over the counter remedies such as Imodium, and Pepto-Bismol to relieve symptoms, particularly when cramping is also an issue. It may be a matter of trial and error to discover the best supplement for you.
Food intolerances to lactose can cause excess gas, bloating and diarrhea, and digestive enzymes are sometimes recommended, as well as staying away from dairy produce.
If dietary changes and supplements have little effect on symptoms, stronger medications may be prescribed:
Anticholinergics (antispasmodics) can alleviate muscle spasms and pain. Even though they have not been proven for specifically treating IBS they are still the most commonly prescribed medication for treating IBS symptoms. They can be taken half an hour before a meal which would normally cause symptoms. However studies suggest that if constipation if a patient's main problem, antispasmodics may not be suitable. They may in fact make the condition worse. Pregnant women should seriously think about avoiding the drug as some studies show that antispasmodics may raise fetal heartbeat and are related to birth defects. The most common brands include Donnatal and Bentyl.
Depending on a patient's symptoms pattern, antidepressants may be an option. If pain and other gastrointestinal discomforts worsen (bloating for example) then this can lead to psychological distress, which in turn can lead to less responsiveness to regular treatment. Antidepressants may be beneficial in treating both the physical and emotional symptoms in such a case. Antidepressants can ease abdominal pain related to IBS, just as they can ease pain in other conditions. Tricyclic antidepressants (TCAs) are often prescribed for IBS. A low daily dosage of 25–125 mg a day (below the range prescribed for actual depression) is effective in 85 percent of IBS cases. Another class of antidepressant called selective serotonin reuptake inhibitors (SSRIs) may also help reduce pain by regulating serotonin levels (the so-called happy hormones) as well as neurotransmitters which play an important part in muscle activity in the intestines. However, SSRIs are typically prescribed in higher dosages (full psychiatric dosages), which means that benefits may be more related to a reduction in stress and anxiety. See also: Stress and IBS.
As both antidepressants and antispasmodics increase the risk of constipation, some doctors prefer to prescribe mild sedatives instead. These work by relaxing the muscles of the gut, examples include Librax and Donnapine. Like any medication, sedatives also have potential side effects which include insomnia; increased heart beat and mouth sores. They can also be habit forming, so do discuss all options with your doctor first.
Lotronex (brand name for the drug alosetron) was approved by the FDA for the treatment of women with severe IBS and diarrhea but who have not responded to conventional therapies. However it is fraught with complications and needs to be monitored very closely. Some women experience great relief from symptoms while others experience severe constipation, even on low dosages of the drug. It should not be prescribed to women whose main symptom is constipation.
See also: IBS Natural Treatment