Irritable Bowel Syndrome

ALTERNATIVE DOCTOR, LLC

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) occurs when muscles in your intestines contract faster or slower than normal. This causes pain, cramping, gassiness, sudden bouts of diarrhea, and constipation.

Two types of IBS exist. In spastic colon IBS, you experience constipation, diarrhea, or both, and you often have pain after eating. Painless diarrhea IBS involves the sudden onset of diarrhea during or after meals, or upon waking. Between 10 and 20 percent of the population has IBS at some time. The syndrome often starts in adolescents or young adults. It affects three times as many women as men and is often associated with stress.

Signs and Symptoms

	Cramping pain in your lower abdomen
	Bloating and gassiness
	Changes in your bowel habits
	Diarrhea or constipation, or both alternately
	Immediate need to move your bowels when you wake up or during or after meals
	Relief of pain after bowel movements
	Feeling of incomplete emptying after bowel movements
	Mucus in your stool

What Causes It?

The underlying cause remains unknown. But the syndrome has no relation to actual disease, and it does not lead to other diseases.

What to Expect at Your Provider's Office

Your health care provider will feel your abdomen to check for signs of pain. He or she will place a gloved finger in your rectum to check its condition. If you're female, you may have a pelvic examination. The provider may use a sigmoidoscope—a flexible instrument inserted into the rectum—to examine your lower colon. You may be asked to provide three days' worth of stool samples. Your provider may also want samples of your blood and urine. The provider may also want an ultrasound or X-rays.

Treatment Options

Treatment Plan

Try to avoid stressful situations or foods that have triggered IBS in the past. Monthly hormonal changes and some drugs can affect your condition. Establishing regular bowel habits can be helpful. Your health care provider may prescribe medications to help you with the symptoms.

Drug Therapies

Prescription

	Antispasmodic agents—reduce the pain from bowel spasm, some also help with depression; take before meals; various side effects
	Antiflatulents—if symptoms indicate

Over the Counter

	Loperamide (Imodium)—for diarrhea
	Bulk-producing agents—such as psyllium (Metamucil) can help with diarrhea or constipation
	Lactase capsules—if lactose intolerant

Complementary and Alternative Therapies

IBS has many underlying causes that can often be successfully treated with alternative therapies. Stress reduction techniques through biofeedback, hypnosis, or counseling can help you deal with stress.

Nutrition

	Removal of known food allergens or irritants is important. The most common food allergens are dairy products, wheat, corn, peanuts, citrus, soy, eggs, fish, and tomatoes. An elimination/challenge trial may help uncover sensitivities. Eliminate all suspected allergens from the diet for two weeks. Add back one food every three days and wait for reaction to the challenge.
	If you suffer from gassiness, eliminate beans, cabbages, and other "gassy" vegetables from your diet, as well as apple juice, grape juice, bananas, nuts, and raisins.
	Fiber supplementation can help reduce pain, cramping, and gas. Supplements include psyllium, flax meal, slippery elm (Ulmus rubra) powder, and marshmallow root (Althea officinalis) powder.
	Digestive enzymes taken 20 minutes before meals can help enhance digestion and normalize bowel function.
	One teaspoon of raw bran with each meal, supplemented by extra fluids, provides fiber reliably.
	Pro-flora supplements such as acidophilus and lactobacillus species taken two to three times per day can help to rebalance normal bowel bacteria and reduce gas and bloating.
	Magnesium 200 mg two to three times per day and B-complex (50 to 100 mg per day) with extra B₅ (pantothenic acid; 100 mg per day) may help reduce the effects of stress.
	Low-fat diets may relieve abdominal pain following meals.

Herbs

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

	Enteric-coated peppermint oil: one to two capsules (0.2 ml peppermint oil per capsule) three times a day after meals
	A tea of fennel seed (Foeniculum vulgare) or ginger root (Zingiber officinalis) taken after meals promotes good digestion.
	A tincture of equal parts of the following before meals (30 drops three times per day): valerian (Valeriana officinalis), passionflower (Passiflora incarnata), anise seed (Pimpinella anisum) extract, meadowsweet (Filependula ulmaria), wild yam (Dioscorea villosa), and milk thistle (Silybum marianum)

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

	Electric heating pads, hot water bottles, and long hot baths can relieve painful spasms and cramping in the abdomen.
	Regular exercise, such as walking, can reduce stress and encourage bowel movements if you are constipated.
	Castor oil pack. Apply oil directly to skin, cover with a clean soft cloth and plastic wrap. Place a heat source over the pack and let sit for 30 to 60 minutes.
	Abdominal breathing helps to induce the relaxation response and may aid normal physiological functioning (such as digestion).

Acupuncture

Acupuncture can help relieve IBS episodes.

Massage

Therapeutic massage may help in reducing the effects of stress.

Following Up

Be aware that the syndrome itself may cause you stress.

Supporting Research

Berkow R, ed. Merck Manual of Diagnosis and Therapy. 16th ed. Rahway, NJ: The Merck Publishing Group; 1992.

Dambro MR. Griffith's Five-Minute Clinical Consult. New York, NY: Lippincott, Williams and Wilkins; 1998.

Koch TR. Peppermint oil and irritable bowel syndrome [In Process Citation]. Am J Gastroenterol. 1998;93:2304–2305.

Liu JH, Chen GH, Yeh HZ, Huang CK, Poon SK. Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol. 1997;32:765–768.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. Rocklin, Calif: Prima Publishing; 1998:396–400.

Pittler MH, Ernst E. Peppermint oil for irritable bowel syndrome: a critical review and metaanalysis. Am J Gastroenterol. 1998;93:1131–1135.

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.