Treatment of IBS is aimed at relieving symptoms
and falls into three categories, lifestyle adjustments,
learning new coping skills, and drug therapy. Lifestyle
adjustments are include:
increasing fiber in the diet (see irritable bowel syn-
drome diet entry)
keeping a food diary to learn which foods are trigger
foods and then avoiding them
drinking at least 6 glasses of water daily to help
prevent constipation
getting regular exercise
eating meals at regular times; not skipping meals
Learning new coping skills may involve psycho-
therapy (talk therapy) or professional counseling to
help resolve problems that are causing stress or learn-
ing techniques to cope with stress. Some of these cop-
ing techniques include biofeedback techniques to
reduce stress, yoga, massage, meditation, deep breath-
ing exercises, progressive relaxation exercises, and
hypnosis.
Drug therapy depends on specific symptoms.
Over the counter anti-diarrheal products such as
loperamide (Imodium) can give the individual better
bowel and reduce the impact of IBS on daily activities.
Over the counter laxatives can be helpful to treat con-
stipation but they must be used sparingly because
regular use creates bowel dependence.
Bulk-forming orfibersupplement laxatives are
generally the safest type of laxative. Some common
brand names of fiber-supplement laxatives are Meta-
mucil, Citrocel, Fiberall, Konsyl, and Serutan. These
must be taken withwater. They provide extra fiber
that absorbs water and helps keep the stool soft. The
extra bulk also helps move materials through the
colon.
Stool softeners help prevent the stool from drying
out. They are recommended for people who should
not strain to have a bowel movement, for example,
people recovering from abdominal surgeries or child-
birth. Brand names include Colace and Surfak.
Stimulant laxatives such as Ducolax, Senokot,
Correctol, and Purge increase the rhythmic contrac-
tions of the colon and move the material along faster.
Lubricants add grease to the stool so that it moves
more easily through the colon. Mineral oil is the most
common lubricant.
Saline laxatives such as Milk of Magnesia draw
water from the body into the colon to help soften and
move the stool.
As of April 2007, the only prescription drug to
treat IBS is alosetron (Lotronex). In the United States,
this drug was temporarily withdrawn from the market
because of serious side effects including four deaths,
but was reapproved with limitations. The drug can
only be prescribed by doctors enrolled in a special
program, and should only be used for cases of severe
diarrhea-type IBS that has failed to respond to all
other treatments. This drug is only approved for use
in women. Tegaserod (Zelnorm), previously pre-
scribed for severe constipation, was withdrawn from
the American market at the request of the Food and
Drug Administration in March 2007 because of seri-
ous heart-related side effects.
Some people with IBS have seen their symptoms
improve when treated with low levels of tri-cyclic anti-
depressants that affect serotonin levels in the brain. The
dosage of these drugs is lower than that used to treat
depression. Serotonin is a neurotransmitter that some
researchers think play a role in IBS Newer selective
serotonin reuptake inhibitor (SSRI) antidepressants
seem to be less effective. People whose symptoms do
no improve with lifestyle changes may want to talk to
their doctor about this and also seek treatment for any
depression or anxiety that accompanies the disorder.Nutrition/Dietetic concerns
The main dietary concern of people with consti-
pation-type IBS is increasing the amount of fiber in
their diet. Insoluble fiber helps material move through
the large intestine faster so that less water is reab-
sorbed by the body and the stool remains softer. Solu-
ble fiber dissolves in water and forms a gel that keeps
the stool soft. Good sources of fiber include apples
with skin, dried beans, pears with skin, brown rice,
oatmeal, and popcorn.Prognosis
Every year the symptoms of about 10% of people
with IBD spontaneously disappear. The reason for this
is not understood. For most people, however, IBS is a
chronic disorder. Symptoms are erratic and change-
able; there are periods of symptoms improve and peri-
ods when symptoms worsen. IBD is not a symptom of
any other disorder, and it does not develop into any
other more serious disease such as inflammatory bowel
disorder or coloncancer.Prevention
Since the cause of IBS is unknown, the disorder
cannot be prevented. Once the disorder is established,Irritable bowel syndrome