digestive disorders
Irritable Bowel Syndrome (IBS)
Treatment of IBS
Eating a normal diet and avoiding gas-producing and diarrhea-producing foods Increasing fiber and water intake for constipation Sometimes drugs Treatment of IBS differs from person to person. If particular foods or types of stress appear to bring on the problem, they should be avoided if possible. For most people, especially those who tend to be constipated, regular physical activity helps keep the digestive tract functioning normally. (For more information about diet and IBS, see theserecommendationsfrom the National Institute of Diabetes and Digestive Disease.) Many people do better eating frequent, smaller meals rather than less frequent, larger meals (for example, 5 or 6 small meals rather than 3 large meals a day). People should try to slow their pace while eating. People with bloating and increased gas (flatulence) should avoid beans, cabbage, and other foods that are difficult to digest. Some people find relief from IBS symptoms by restricting their intake of foods that are high in certain Carbohydrates, Proteins, and Fats called fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These foods are collectively called FODMAPs. FODMAPs are carbohydrates that are poorly absorbed and rapidly fermented by bacteria in the small intestine, leading to increased gas and discomfort. , an artificial sweetener used in some foods, drugs, and chewing gums, should not be consumed in large amounts. Fructose, a sugar found in fruits, berries, and some plants, should be eaten only in small amounts. People who have IBS and who cannot digest the sugar lactose (called Lactose Intolerance ), which is found in milk and other dairy products, should consume dairy products only in moderation. People can try reducing their intake of the foods mentioned above one at a time and noting whether their symptoms change, or they can try a low-FODMAP diet, which restricts all of these foods. A low-fat diet helps some people, particularly those whose stomach empties too slowly or too quickly. Constipation can often be relieved by eating more fiber and drinking more water. People with constipation can takepsylliummucilloid supplements with two glasses of water. Increasing the dietary fiber may aggravate flatulence and bloating. Occasionally, such flatulence may be reduced by switching to a synthetic fiber preparation (such asmethylcellulose). Certain laxativesare reasonably safe and often effective for people with constipation. Such laxatives include those containingpolyethylene glycoland stimulant laxatives, such as those containingbisacodylorglycerin. The prescription laxative drugslubiprostone,linaclotide,plecanatide, andtenapanormay also relieve constipation.Prucaloprideis another drug that may help people who have chronic constipation. , can sometimes relieve abdominal pain by blocking spasms of the intestinal muscles. However, these drugs often cause anticholinergic side effects ( see Anticholinergic: What Does It Mean? ), such as dry mouth, blurred vision, or difficulty urinating. Antidiarrheal drugs,such as diphenoxylate orloperamide, help people with diarrhea.Eluxadolineis another drug that may be given to some people who have severe diarrhea caused by IBS. Theantibioticrifaximinmay be prescribed to relieve symptoms of diarrhea, bloating, and abdominal pain. Alosetronis occasionally used for diarrhea in older women for whom other drugs are ineffective, butalosetronhas been associated with increasing the risk of ischemic colitis, so its use is restricted in the United States. Certain antidepressantshelp relieve symptoms of abdominal pain as well as diarrhea and bloating in many people. Long-term use of certain antidepressants such asnortriptylineordesipramineis often helpful. Antidepressants may not only relieve pain and other symptoms but also may help relieve sleep problems and depression or anxiety. Probiotics,which are bacteria naturally found in the body that promote the growth of good bacteria, may be given. Aromatic oils,such as peppermint oil, often help relieve pain caused by cramps in some people. Behavior modification techniques (such as cognitive-behavioral therapy), Psychotherapy , and 