HCA imageIrritable bowel syndrome (IBS) does not easily fit into the traditional medical model. Researchers have not yet come up with a coherent scientific explanation, let alone a cause, for its debilitating symptoms. This means that there is no cure or even a comprehensive treatment. Doctors can offer a way to manage symptoms, though.

A Common Diagnosis

Doctors diagnose IBS in women more often than in men. The main symptoms are abdominal pain, usually associated with bloating and gas, and a change in bowel movements ( diarrhea , constipation , or alternating bouts of each). Mucus may be present with diarrhea, but there is no blood or pus.

Because tests show no abnormalities, doctors usually diagnose IBS only after ruling out similar diseases. Doctors suspect IBS when a person experiences abdominal pain with at least two of the following features:

  • Pain is relieved after a bowel movement
  • The onset of pain is associated with diarrhea or constipation
  • The onset of pain is associated with a change in the form of the stool (loose, watery, or pellet-like)

Complementary Approaches

Dietary Restrictions

Since IBS primarily affects the GI tract, diet is a good place to start. Many people benefit from avoiding certain foods and ingredients, such as:

  • Caffeine
  • Alcohol
  • Fatty foods
  • Gas-producing vegetables

For those who find a connection between their symptoms and what they eat, avoiding those foods can be effective.

Fiber

Fiber may improve the colon's function and reduce symptoms, especially in people who tend to be constipated. Scientific research suggests that 20-30 grams of fiber per day is optimal. Good sources of fiber include:

  • Whole grains, fruits, vegetables, and legumes
  • Raw bran
  • Psyllium seeds
  • Flaxseeds

Peppermint

Of the many herbs and supplements that have been recommended for IBS, peppermint oil is one of the few backed by some scientific evidence. The recommended dose is 0.2 milliliter (ml) capsules three times daily after meals. Be sure to take the enteric-coated form, so that the capsule will not be broken down in the stomach before it reaches the intestines. Talk to your doctor before taking any herbs and supplements. They could affect medicines that you are taking or conditions that you have.

Stress Management

Stress management and exercise may be able to ease IBS symptoms. Some treatments that may be used to decrease stress include:

  • Relaxation response —the use of medicine and similar techniques to soothe the response to stress
  • Biofeedback —the use of computers and probes to dampen the physiologic manifestations of stress
  • Cognitive-behavioral therapy —teaching people to reframe the way they perceive pain and to modify their maladaptive responses

Regular aerobic exercise may help to mitigate stress and help normalize the muscular activity of the intestines. This may be particularly helpful for people with constipation.

Education

Anther important part of treatment is becoming educated about IBS and ways to reduce the symptoms. Joining a support group may also be a good way to learn about the condition and to share your experiences with others.

Medications

In addition to lifestyle changes, there are a number of medicines that may be helpful in treating the individual symptoms of IBS. In some cases, these medicines may be used in combination. Examples include:

  • Antispasmodic agent (eg, dicyclomine, alverine citrate)
  • Antiflatulant (eg, simethicone)
  • Antidiarrheal agent (eg, loperamide )
  • Low-dose antidepressant
  • Probiotics (eg, acidophilus)
  • Pain reliever (eg, acetaminophen )—may help with crampy abdominal pain
  • Serotonin receptor agonists and antagonists (also called 5-HT3 antagonists)—may be helpful for treating diarrhea, as well as treating other IBS symptoms, like abdominal pain in women (eg, alosetron )

These medicines, while often helpful, are no substitute for a comprehensive lifestyle approach. By finding effective ways to manage stress, exercise regularly, and modify your diet you can attempt to address the complex underlying causes of IBS.