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Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome Treatments & Services

Irritable bowel syndrome (IBS) treatment overview
Medications
How does stress affect IBS?
Changes in diet
Schedule an appointment

Irritable bowel syndrome (IBS) treatment overview

Unfortunately, many people suffer from IBS for a long time before seeking medical treatment. Up to 70 percent of people suffering from IBS are not receiving medical care for their symptoms. No cure has been found for IBS, but many irritable bowel syndrome treatments are available to alleviate the symptoms. Your doctor will give you the best treatments for your particular symptoms and encourage you to manage stress and make changes to your diet.

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Medications

Medications are an important part of relieving symptoms. Your doctor may suggest fiber supplements or laxatives for constipation or medicines to decrease diarrhea, such as Lomotil® or loperamide (Imodium®). An antispasmodic is commonly prescribed, which helps to control colon muscle spasms and reduce abdominal pain. Antidepressants may relieve some symptoms, and thus may be used in the treatment of irritable bowel syndrome. However, both antispasmodics and antidepressants can worsen constipation, so some doctors will also prescribe medications that relax muscles in the bladder and intestines, such as Donnapine® and Librax®. These medications contain a mild sedative, which can be habit forming, so they need to be used under the guidance of a physician.

A medication available specifically to treat IBS is alosetron hydrochloride (Lotronex®). Lotronex® has been re-approved with significant restrictions by the U.S. Food and Drug Administration (FDA) for women with severe IBS who have not responded to conventional therapy and whose primary symptom is diarrhea. However, even in these patients, Lotronex® should be used with great caution because it can have serious side effects such as severe constipation or decreased blood flow to the colon.

With any medication, even over-the-counter medications such as laxatives and fiber supplements, it is important to follow your doctor’s instructions. Some people report a worsening in abdominal bloating and gas from increased fiber intake, and laxatives can be habit-forming if they are used too frequently.

Medications affect people differently, and no one medication or combination of medications will work for everyone with IBS. You will need to work with your doctor to find the best combination of medicine, diet, counseling, and support to control your symptoms.

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How does stress affect IBS?

Stress - feeling mentally or emotionally tense, troubled, angry, or overwhelmed - can stimulate colon spasms in people with IBS. The colon has many nerves that connect it to the brain. Like the heart and the lungs, the colon is partly controlled by the autonomic nervous system, which responds to stress. These nerves control the normal contractions of the colon and cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress. Stress makes the mind more aware of the sensations that arise in the colon, making the person perceive these sensations as unpleasant.

Some evidence suggests that IBS is affected by the immune system, which fights infection in the body. The immune system is affected by stress. For all these reasons, stress management is an important part of treatment for IBS. Stress management options include:

  • Stress reduction (relaxation) training and relaxation therapies such as meditation
  • Counseling and support
  • Regular exercise such as walking or yoga
  • Changes to the stressful situations in your life
  • Adequate sleep

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Changes in diet

For many people, careful eating reduces IBS symptoms. Before changing your diet, keep a journal noting the foods that seem to cause distress. Then discuss your findings with your digestive disease specialist. You may want to consult a registered dietitian who can help you make changes to your diet. For instance, if dairy products cause your symptoms to flare up, you can try eating less of those foods. You might be able to tolerate yogurt better than other dairy products because it contains bacteria that supply the enzyme needed to digest lactose, the sugar found in milk products. Dairy products are an important source of calcium and other nutrients. If you need to avoid dairy products, be sure to get adequate nutrients in the foods you substitute, or take supplements.

In many cases, dietary fiber may lessen IBS symptoms, particularly constipation. However, it may not help with lowering pain or decreasing diarrhea. Whole grain breads and cereals, fruits, and vegetables are good sources of fiber. High-fiber diets keep the colon mildly distended, which may help prevent spasms. Some forms of fiber keep water in the stool, thereby preventing hard stools that are difficult to pass. Doctors usually recommend a diet with enough fiber to produce soft, painless bowel movements. High-fiber diets may cause gas and bloating, although some people report that these symptoms go away within a few weeks. Increasing fiber intake by two to three grams per day will help reduce the risk of increased gas and bloating. For information about diets for people with celiac disease, please see the celiac disease fact sheet from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Drinking six to eight glasses of plain water a day is important, especially if you have diarrhea. Drinking carbonated beverages, such as sodas, may result in gas and cause discomfort. Chewing gum and eating too quickly can lead to swallowing air, which also leads to gas.

Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may help IBS symptoms. Eating meals that are low in fat and high in carbohydrates such as pasta, rice, whole-grain breads and cereals (unless you have celiac disease), fruits, and vegetables may help.

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Schedule an appointment

To schedule an appointment with a Temple Digestive Disease Center Physician, click here or call 1-800-TEMPLE-MED [1-800-836-7536].

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Sources:

National Digestive Diseases Information Clearinghouse (NDDIC), National Institutes of Health (NIH) - NIH Publication No. 07–693, September 2007

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