This will likely require a multi-faceted approach, which might include prescription or over-the-counter medication, dietary changes, and psychotherapy.
To help guide and standardize this process, the American College of Gastroenterologists in 2021 put out new clinical guidelines.
Whether youre newly diagnosed or looking for treatments to add to your management plan, they may help you and your healthcare provider decide on your next step.
If you havent already done so, it is essential that you see a healthcare provider to discuss any ongoing digestive symptoms you may be havingeven if youve been diagnosed with IBS and are following a recommended treatment plan to the letter.
In the event your condition has changed, your treatment approach must evolve as well.
The simple act of eatingand eating large or fatty meals, in particularcan stimulate bowel contractions.
Because of that, changing your eating habits is one of the most common ways to manage IBS.
Afood diarycan help you track what you eat and how it makes you feel.
If you notice your symptoms tend to flare after eating a certain food, consider eliminating that food (and similar ones) for a period of about three months to see if this has any effect on your IBS.
If not, try eating the food again and repeat the process with the next food on your list.
Common food and drink culprits include:1
Stress and hormonal changes also contribute to IBS symptoms.2
Because of this, a food you tolerate poorly on one occasion may be just fine on another.
You may also consider an elimination diet to rule outgluten sensitivity,lactose intolerance, orfructose malabsorption.
FODMAP stands for fermentable oligosaccarides, disaccarides, monosaccharides, and polyols.
These carbohydrates dont absorb well into your digestive system.
Research suggests they can be particularly problematic for people with IBS because they can compound your issues with gas, bloating, abdominal pain, diarrhea, and/or constipation.
Following a low-FODMAP diet can be challenging, but it has some sound research support for its effectiveness3 and the ACGs 2021 guidelines recommend trying it.
The diet involves eliminating FODMAPS from your diet for six to eight weeks and then gradually adding them back to see how well you tolerate them.
Increasing your fiber intake is generally recommended for IBS due to its many health benefits and its ability to make your stool a better consistency.
However, it is best to addfiberslowly to allow your body time to adjust.
Evidence suggests that people with IBS benefit more from soluble fiber than from insoluble fiber4and its strong enough to receive backing from the ACG.
To ease the stress on your digestive system, its recommended that you eat smaller, more frequent meals instead of the traditional three big ones per day.
One possible exception is that for constipation, a large breakfast may help encourage intestinal contractions and the urge to have a bowel movement.
You have a wide variety of OTCs to choose from for digestive symptoms.
While you can get these without a prescription, its best to check with your healthcare provider before using any OTC product for IBS.
A few of the more commonly used OTC drug options include:
The ACG recommends against probiotics, however, saying that studies so far have been too small and inconsistent to prove any benefits.
Traditionally, medication options for IBS have been limited.
Luckily, that situation is changing rapidly as new medications are developed.
Some are created specifically for IBS while others are meant for different conditions but can help alleviate IBS symptoms.
Several newIBS drugshave come onto the market.
They typically work on receptors within the large intestine to bring about IBS symptom relief.
Receptors are parts of cells that other substances can communicate with in order to change the cells behavior.
Options for the treatment ofconstipation-predominant IBS (IBS-C)include:
Of these, the ACG recommends lubiprostone, linaclotide, and plecantide. It recommends tegaserod in women under 65 with no cardiovascular risk factors who havent responded to other treatments.
The 2021 guidelines dont mention prucalopride.
So far, only one medication has come on the market fordiarrhea-predominant IBS (IBS-D):Viberzi (eluxadoline).
This medication is recommended by the ACG.
People are often surprised when they hear thatantibiotics may be prescribed for IBS, as taking a round of antibiotics can often make IBS symptoms worse.
However, the specific antibiotics used to treat IBS are not absorbed in your stomach.
Rather, they target bacteria in your small and large intestine.
Of this class, onlyXifaxan (rifaximin)used for the treatment of non-constipation IBShas Food and Drug Administration (FDA) approval and is recommended by the ACG for IBS-D.
Antidepressant medicationscan affect how your digestive system functions and can also alleviate some types of pain, including the visceral pain of IBS.
They also can safely be taken for a long period of timewhich is an definite advantage when you have a chronic disorder like IBS.
Tricyclic antidepressants are the most often used antidepressants to treat IBS and the ones favored by the ACG.
They include:
Healthcare providers are more likely to recommend an antidepressant if your symptoms have not been addressed through lifestyle and dietary modifications, and if you also experiencedepression and/or anxiety alongside your IBS.
In those cases, your gastroenterologist may work closely with psychiatrist.
Another type of antidepressant calledselective serotonin reuptake inhibitors (SSRIs)is prescribed less often for IBS.
This class includes:
Antispasmodics are the most frequently prescribed medications for IBS as theyre believed to help to ease symptoms of abdominal pain and cramping, particularly for people who have IBS-D.
However, the ACG guidelines recommend against their use, stating that the only studies are outdated and of poor quality, and that side effects are common.
Antispasmodics work best if taken 30 to 60 minutes prior to eating and may be better at providing short-term, as opposed to long-term, relief of symptoms.5
A variety of psychological therapies have been studied for their effectiveness in reducing the frequency, intensity, and duration of IBS symptoms, includingcognitive behavioral therapy (CBT),hypnotherapy, stress management, andrelaxation exercises.
Of these,CBTandgut-directed hypnotherapyhave the most solid research supporting their effectiveness in reducing IBS symptoms6and both are recommended by the ACG.
CBT is a form of psychotherapy in which you are taught strategies for modifying maladaptive thinking patterns, as well as new behaviors for managing anxiety and handling stressful situations.
Hypnotherapy involves getting into a relaxing and comfortable state of consciousness in which specific suggestions are offered in order to lead to a permanent change in behavior.
The recommendation of these treatments doesnt imply that IBS is a psychological illness.
Rather, theyre a way to build coping skills and better habits so you can handle your IBS long-term without the risk of possible negative side effects of medication.
Studies have shown that enteric-coatedpeppermint oilhas strong antispasmodic qualities and, thus, may be effective in easing IBS pain.5
The ACG gives it a conditional recommendation for abdominal pain and overall symptoms based on what it calls low-quality evidence.
However, a 2019 review of evidence found it be quite promising, while also a generally safe and well-tolerated treatment.
The enteric coating is an important part of taking peppermint oil. Enteric means its broken down in the intestines, not the stomach, where the peppermint can cause heartburn.8
In addition to antispasmotics, probiotics, and PEG, the ACG guidelines recommend against these IBS treatments:
The negative recommendations were based on low evidence and/or inconsistent studies that have failed to establish effectiveness or proper dosages/procedures.
None of these treatments is considered harmful.
Additional Reading
Emergency Live Even MoreLive: Download The New Free App Of Your Newspaper For IOS And Android
Wales Bowel Surgery Death Rate Higher Than Expected
Irritable Bowel Syndrome (IBS): A Benign Condition To Keep Under Control
Colitis And Irritable Bowel Syndrome: What Is The Difference And How To Distinguish Between Them?
Irritable Bowel Syndrome: The Symptoms It Can Manifest Itself With
Chronic Inflammatory Bowel Disease: Symptoms And Treatment For Crohns Disease And Ulcerative Colitis
Experts Call For Changes To The Way IBS (Irritable Bowel Syndrome) Is Diagnosed
Very Well Health
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