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Treatment Options for IBS
IBS is not always easy to treat. While some people experience only mild symptoms, others can have significant digestive problems that interfere with day-to-day life. Although several drugs are currently available for this condition, you should know there are other therapies available that could help you better manage your IBS symptoms.
Paying attention to what you eat is important, and following a low FODMAP diet can be beneficial. Some herbs and alternative therapies also show promise for IBS patients. Always talk to a healthcare professional before starting a new alternative therapy, to learn more about possible drug interactions and side effects. A dietician can help with a customized diet. If you consider acupuncture, chiropractic or other alternative therapies make sure you consult an experienced, licensed professional in that field.
1. Medication
A variety of drugs are used to relieve digestive problems such as bowel spasms, gas, diarrhea or constipation, and two drugs have been specifically approved by the FDA as treatment options for IBS. Here is a summary of them:
Anticholinergic Drugs
Anticholinergic drugs work by relaxing the muscles of the digestive tract and thus improving bowel spasm. Hyoscyamine (Levin and Levine) and dicyclomine (Bentyl) belong to this class of drugs. These drugs block a chemical in the smooth muscle of the stomach and intestines, causing them to relax and reduce the cramping.
These drugs may interfere with other drugs such as antihistamines, monoamine oxidase inhibitors (MAOIs) (eg. phenelzine), other anticholinergics, tricyclic antidepressants and narcotic pain medicines. Possible side effects include drowsiness, dizziness and blurred vision, and these side effects may be aggravated if you drink alcohol. Therefore you should avoid alcohol. If you feel lightheaded or dizzy avoid driving.
Antiflatulents
Antiflatulents help reduce excessive gas and bloating. A common antiflatulent prescribed for IBS is simethicone (Phazyme or Mylicon). Simethicone helps relieve painful symptoms and pressure caused by excessive gas accumulated in the stomach and intestine, and can be used by children and adults. It has an excellent safety profile, with no known side effects. It may, however, interact with drugs prescribed to improve thyroid function.
Anti-Diarrhea Medications
Anti-diarrhea medications are used for diarrhea predominant IBS, and a commonly prescribed drug is loperamide. Lopermide works by slowing the digestion, allowing the gut more time to absorb nutrients and fluids from the food and reducing the amount of stool. Possible side effects include stomach pain and bloating, worsening of the diarrhea or constipation, dizziness , fatigue and skin rashes. It interferes with many drugs including hyoscyamine, antihistamines, aspiring and some painkillers.
Antidepressants
Antidepressants are used to relieve symptoms of depression and anxiety associated with IBS. When given in much lower doses than those prescribed for depression, antidepressants can also help improve symptoms of IBS like pain, bloating, or feeling unable to pass the stool.
Amitriptyline (Elavil) is an example of antidepressant drug recommended for IBS. Side effects include abdominal discomfort, blurred vision, tingling, numbness, chest pain, headaches, and nausea, vomiting and muscle spasms. This drug can interact with many other prescription drugs – for example antihistamines, some painkillers, hyoscyamine, some anti-asthma and anti-seizure drugs.
Lubiprostone (Amitiza)
Lubiprostone is a drug specifically approved for the treatment of IBS. It works by increasing the fluid in the gut, which increases the intestinal muscle movements and therefore helps speed the passage of the stool. It is recommended for women who suffer from constipation that has not responded to other drugs. Lubiprostone is associated with side effects such as dizziness, diarrhea, and bloating, headaches, fatigue and stomach pain and may interfere with the drug idelalisib.
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2. Natural Supplements and Herbs
A variety of supplements are widely used by IBS sufferers. Among all of them, the following have shown efficacy in scientific studies:
- Probiotics have been found to improve symptoms of IBS (i.e. abdominal pain, gas and constipation) by helping the digestive tract to work better.
- Flaxseeds help relieve constipation, bloating and gas associated with IBS, and according to one study works better than the commonly prescribed drug psyllium.
- Melatonin had also shown potential benefits to manage IBS symptoms.
Among herbs, peppermint oil (enteric coated formula) can help improve gas and abdominal cramps. A combination of Chinese herbs that included ginger and wormwood was also found beneficial for IBS in research studies.
See a healthcare professional specialized in alternative medicine to learn more about herbs, including the proper doses and possible interactions with other herbs or drugs. It is also important to choose a high quality brand, because supplements are not evaluated by the FDA for safety and efficiency.
There aren't many controlled studies on exercise for IBS, but there’s a good deal of evidence to suggest that activity can change things for the better.
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3. Alternative Medicine Therapies
Based on a review of studies from the University of Maryland Medical Center, alternative medicine may help improve symptoms of IBS. All three of these therapies have an excellent safety profile when performed by licensed professionals and limited side effects.
Acupuncture
Various studies found that acupuncture can improve bloating and your overall health. Besides using acupuncture needles to specific points, a doctor specialized in traditional Chinese medicine may recommend moxibustion (where an herb mugwort is burned and applied on the body), Chinese herbs and special dietary changes.
Homeopathy
Homeopathy also may be beneficial for IBS, suggest some research studies. Homeopathic remedies are derived from plants and other natural sources, and are prescribed based on the physical and emotional symptoms of a person.
Chiropractic
Although there are no well-designed studies showing that chiropractic medicine works for IBS, chiropractors suggest that this form of therapy can help alleviate symptoms. This therapy involves spinal manipulation with the goal of improving the function of the nerves that control digestive tract.
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4. Nutrition
IBS is associated with problems digesting foods, especially some forms of sugar. It has been also linked with various food sensitivities and improper absorption of the nutrients from foods. A dietician can help provide an individualized plan to better manage IBS symptoms.
Generally speaking, a healthy diet will include fresh fruits and vegetables, whole grains, lean meats and fish, healthy oils, nuts and seeds. Processed foods should be avoided, and so should alcohol, coffee, and carbonated and sugary beverages.
A low FODMAP diet has shown benefits for improving IBS symptoms. Based on this diet, foods that are high in short chain carbohydrates collectively known as FODMAPs (Fermentable Oligo-saccharides, Di-saccharides, Mono-saccharides And Polyols) should be temporary eliminated from the diet. Examples of high FODMAPs include fruits like apples, pears and watermelon, vegetables like asparagus, beans, wheat and other grains, most dairy products and various sugars found in abundance in processed foods.
Read more about treatments for IBS over at NewLifeOutlook.
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