Irritable bowel syndrome, or IBS, is a chronic disorder of the large intestine. It is important to note that the condition does not present any complications if treated properly; usually in the form of dietary and lifestyle adjustments, with specialized medicinal treatment reserved for the rare few.
For Mild Symptoms:
1- Eating Schedule Adjustments:
Regulating meal times is one of the most basic irritable bowel syndrome treatment and is recommended for everyone who has the illness, those with IBS-D (IBS with diarrhea) should opt for multiple small-portioned meals a day instead of the regular 3 meals to help harden the stool.
2- Dietary Changes:
In addition to consuming more high-fibre foods, like dried fruits, whole-wheat bread and high-fibre cereal to help relieve constipation (IBS-C) by easing the food’s passage through the intestine, IBS patients can benefit from the following dietary changes:
- Avoid High-Gas Foods like alcoholic and caffeinated beverages, raw fruit, cabbage, cauliflower, broccoli and certain other vegetables in case of frequent gas or bloating.
- Eliminating Dietary Gluten such as wheat, rye, and barley may reduce diarrhea in some individuals.
- A Low-FODMAP (Fermentable Oligo-, Di- and Monosaccharides, and Polyols) Diet can help reduce bloating by minimising the consumption of certain FODMAP-containing foods (garlic, onions, beans, wheat, dairy products, etc.) which release gases by fermenting rapidly in the gut.
3- Keep A Food Diary:
Since people have different reactions to different foods, keeping a record of what you eat is the best way to figure out what may be causing this reaction in your body. This will make dietary changes much easier as you’ll know exactly what to cut out or add. You will also be able to save yourself a lot of time and trouble with just a few pages of notes.
For Moderate to Severe Cases:
Some people may require additional treatment alongside the above dietary changes if symptoms become unmanageable or disruptive:
1- Fiber Supplements:
Along with steadily increasing the amount of dietary fibre over the course of several weeks, taking fibre supplements with fluids can aid in constipation control, although they may also worsen gas and cramps. Some patients may further require laxatives such as magnesium hydroxide or polyethylene glycol.
2- Anti-Diarrheal Medication:
While OTC medications like Imodium can aid in diarrhea suppression, some patients may require prescription-grade bile acid binders like colestipol and cholestyramine. However, these binders may also cause bloating.
These nerve response suppressants can help reduce painful bowel spasms caused by miscommunication between the brain and the intestine in people with episodic instead of persistent diarrhea. They may, however, cause dry mouth, constipation and blurred vision.
While tricyclic antidepressants can help relieve severe diarrhea and abdominal pain by inhibiting the neurons that control the intestines, SSRI (Selective Serotonin Reuptake Inhibitors) antidepressants works to reduce severe abdominal pain with constipation. However, patients with IBS symptoms without depression may only be prescribed a minimal dosage; with side-effects being drowsiness, dry mouth, dizziness, and blurred vision.
The following medication has been approved for irritable bowel syndrome treatment in certain individuals who are unresponsive towards any of the above treatments:
Eluxadoline reduces severe diarrhea by decreasing fluid secretion and muscle contractions in the intestine. Abdominal pain, nausea, and mild constipation are common side-effects, while some individuals may also develop pancreatitis.
Alosetron relaxes the colon and slows waste movement through the bowel to treat severe IBS-D in women. However, it should only be considered after all other treatments fail due to life-threatening side-effects.
Lubiprostone relieves constipation by increasing fluid secretion in the small intestine. Like Alosetron, it is only prescribed for women with severe, unresponsive IBS-C.
Linaclotide also works to reduce constipation like Lubiprostone. However, it is not suitable for patients 17 or under; with minor side-effects being abdominal pain, nausea, and diarrhea. Major side-effects include arm and leg swelling, breathing issues, fainting, and heart palpitations.
Rifaximin controls diarrhea by decreasing the number of harmful bacteria in the intestine.
Although research is being conducted on newer IBS treatments like coated peppermint oil tablets and Serum-derived Bovine Immunoglobulin/protein Isolate (SBI), the above treatments are currently most effective in IBS symptom control. If you have been diagnosed with IBS, consult with your doctor on the right treatment for you. You can also book an appointment with a top gastroenterologist in Karachi, Multan and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your gastric concerns.