Irritable bowel syndrome can have a significant impact on a person’s quality of life, as they struggle to deal with symptoms such as abdominal pain, diarrhoea and bloating. In addition, they may find that they are unable to work or go out in public. Some people even suffer from depression. Fortunately, while it can be distressing, irritable bowel syndrome does not cause long-term health problems or increase the risk of colon cancer. There are a variety of treatment options, both dietary and pharmacologic. These treatments should be tailored to each individual and should be discussed with a health care provider.
The first step in treatment is to reassure the patient that there is no organic disease and that the symptoms are normal. Then, they need to establish the cause of the symptoms, if any. This can be done by taking a complete medical history, including a history of recent stool samples or blood test results, and by performing a physical exam, which includes digital rectal examination.
If the doctor does not find a physical reason for the symptoms, they will probably want to perform further tests. This could include stool studies to check for infection or to see if the intestine is having trouble taking in nutrients, which would be a sign of malabsorption. Additional tests might include a colonoscopy or a CT scan of the abdomen and pelvis.
Many patients with IBS can improve their symptoms by modifying their diets. For example, if the problem is with bloating or abdominal pain, eliminating foods that can trigger these symptoms might help, such as wheat products, dairy foods, onion, chocolate and caffeine-containing drinks. However, this should be done with the guidance of a dietitian to ensure that the body is getting the vitamins and minerals it needs.
There are a number of medications that can be used to treat the different symptoms of IBS. Some of these are designed to relieve constipation, while others are intended to ease diarrhea. Those that are designed to treat constipation might include fibre and osmotic laxatives, or antispasmodic drugs. Those that are intended to ease diarrhea might include alosetron (Lotronex), a medication that slows the movement of waste in the colon, or metronidazole (Flagyl).
Some patients with IBS also have an increased sensitivity to the presence of gas, so they may experience pain and discomfort when certain foods are eaten. In these cases, the symptoms might be relieved by eating foods that are less likely to produce gas, such as lean meats, fish and green vegetables.
Those who have symptoms of IBS that are related to anxiety might benefit from psychotherapy. This can help the person learn to cope with the stress and anxiety that may be triggering the symptoms of IBS. Behavioral therapy can also be useful for helping the person control their diet and exercise more regularly, or to relax and reduce stress levels. It is important for patients to have a strong relationship with their healthcare provider, as they may need frequent follow-up visits as the treatment plan is refined.