Irritable Bowel Syndrome (IBS)
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- What is IBS?
- Symptoms of IBS
- Causes of IBS
- Prevention of IBS
- Risk factors for IBS
- Complications of IBS
- When to see a doctor about IBS
- Diagnosis of IBS
- Conventional treatment of IBS
- Alternative/complementary treatment of IBS
- Living with IBS
- Caring for someone with IBS
Conventional treatment of irritable bowel syndrome (IBS)
Since the cause of IBS is not known, conventional treatment is difficult and instead just focuses on alleviating symptoms, which is tailored for each patient's particular symptoms. There is a slight focus on natural or complementary treatment even by conventional doctors because current drug treatments for irritable bowel syndrome (IBS) are of limited value to the patient.
Dietary modifications
Conventional medicine recommends that certain additions and limitations to the diet seem to improve symptoms in some people:
- Increase fibre - edible plant sources of fibre should be gradually incorporated into the diet to promote healthy bowel movements and prevent constipation. Soluble fibre, especially from oats and psyllium are especially recommended as they both really help the bowel to function more normally. People who have not had much fibre in their diet are recommended to add it very gradually to prevent symptoms from getting worse (and to drink lots of water and fluids)
- Increase fluid intake - drinking enough water is necessary to help hydrate the body adequately and to help with constipation symptoms especially. It is recommended to drink at least eight glasses of water every day, a little more if exercising vigorously
- Reduce foods that produce gas - certain foods such as beans and cruciferous vegetables (broccoli, cabbage, cauliflower and brussels sprouts) produce a lot of gas (flatulence) and bloating. These foods are recommended to be limited in the diet to alleviate some of the symptoms of irritable bowel syndrome (IBS)
Lifestyle modifications
Conventional medicine recommends that certain lifestyle modifications are used to help reduce severity and duration of symptoms and improve the well being overall:
- Exercise - regular exercise may reduce stress (which is often associated with aggravation of IBS symptoms) and it also helps with well-being in general
- Relax - the symptoms associated with IBS seems to get worse under periods of stress, so relaxation is a must. The gastrointestinal tract is especially susceptible to stress and strain, so any form of relaxation is recommended - yoga, meditation, tai chi, visualisation
- Stop smoking - smoking cigarettes irritates the bowel and can make IBS symptoms worse, so it is recommended to stop smoking in order to help symptoms and get better
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Peppermint oil
Conventional gastroenterologists and general practitioners are are recommending peppermint oil to help alleviate symptoms of irritable bowel syndrome (IBS)), as it helps to reduce spasms in the bowel by relaxing it and assisting it in normal contractions.
The peppermint oil capsules made for IBS are coated with an enteric (protective) coating, which only dissolves and releases the peppermint oil once it enters the bowel.
Peppermint oil generally has no side effects for most people, although it can cause indigestion or allergic reactions (but these are not common side effects).
Medications
Most medications recommended for irritable bowel syndrome will only just treat the symptoms of this condition and not the cause (which is not yet known). In addition, some medications are not legal in Australia as they have too many side effects, so caution is advised:
- Anti-diarrhoeals - are used to treat and control diarrhoea symptoms associated with irritable bowel syndrome (IBS) by slowing the movement of food in the bowel to form more bulkier stools. Some common ones are: Immodium, Loperamide. These medications are normally safe to take long term, except they should not be used in children, the elderly. Anti-diarrhoeal medications should definitely not be used in a bout of gastroenteritis or inflammatory bowel disease (IBD) as they can produce potentially dangerous side effects
- Anticholinergics - are basically anti-spasmodic medications as they reduce the spasms in the bowel by relaxing the bowel muscles and slowing the churning and contractions in the bowel to alleviate cramps. Common drugs are: Buscopan, Atrobel, Colofac. These drugs have minor side effects: dry mouth, constipation, sleepiness
- Anti-depressants - these medications are used to relax and calm the nerves in the bowel and only very small doses of anti-depressant medications are required for this purpose. Mostly commonly used medications are: SSRIs (selective serotonin re-uptake inhibitors) such as Paxil, Prozac, Zoloft and tricyclics such as Norpramin, Surmontil, Tofranil. Anti-depressants have side effects such as: diarrhoea, restlessness, nervousness, dry mouth, drowsiness, low blood pressure and depression
- Cholestyramine - is used for treating diarrhoea symptoms associated with IBS. It binds with the bile salts to prevent diarrhoea. It is not a common medication for diarrhoea, but is sometimes used.
- Laxatives - used for assisting with constipation symptoms and work by helping the eliminate the stools from the bowel. There are two types: (1) Osmotic laxatives, which include Movicol, Lactulose and Epsom salts, the best of which is epsom salt as it produces the least side effects; (2) Stimulant laxatives, which include senna, Ford pills and Senokot, all of which irritate the bowel after some use, so are not recommended long term
- Stool-bulking agents - this natural supplement is used for assisting with constipation symptoms and works by softening the stools and giving them bulk, to help them move through the bowel properly without getting stuck. The best ones are: Metamucil, Normafibre and Fybrogel
- Alosetron - this medication is used in women who do not relief from other IBS treatment and should only be used short-term. It is used when severe, chronic, diarrhea-predominant IBS is present
- Tegaserod - this medication seems to assist women with IBS associated with constipation; it stimulates the digestive tract to maintain movement, so decreases the risk of developing constipation. Unfortunately the effect of this medication seems to dissipate with longer-term use and it is also expensive. It is not listed on the PBS, which means it is not subsidised in Australia
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