Managing Irritable Bowel Syndrome

Irritable bowel syndrome(IBS) is not a disease; it is a group of symptoms that occur together that affect the large intestine. One in five Americans and twice as many women as men experience symptoms of IBS. Though no specific cause is known, several factors may contribute to IBS, including heredity, lifestyle, allergies, an infection or an abnormally large number of bacteria growing in the intestine.
The best way to manage IBS is to understand what may cause episodes of discomfort and then work to eliminate or minimize them. While medication, stress management and supplements can help, the focus should be on diet and eating habits.
  • Establish Regular Eating Habits. Eating at regular times helps regulate your bowels.
  • Eat Small, Frequent Meals Instead of Large Ones. This will ease the amount of food moving through your intestinal tract.
  • Eat Fiber-Rich Foods. Try whole fruits, vegetables (including beans) and whole grains like rolled oats, brown rice and whole-wheat bread. Make changes slowly. Fiber helps move food through your intestine, but it takes time for your body to adjust to eating more. Adding too much fiber too quickly may result in gas, bloating and cramping.
  • Drink Enough Fluids. Fiber draws water from your body to move foods through your intestine. Without enough water and fluids you may become constipated.
  • Watch What You Drink. Alcohol and caffeine can stimulate your intestines and cause diarrhea. Artificial sweeteners that contain sugar alcohols like sorbitol, mannitol and xylitol may cause diarrhea too. Carbonated drinks can produce gas.
  • Identify Problem Foods and Eating Habits. Keeping a food diary during flare-ups can help you figure out what you may be eating that’s causing a problem.
Although the focus should be on diet, many people with IBS turn to complementary health practices to help relieve their symptoms, and there is emerging evidence that some of these practices may have modest benefits.
If you are thinking about a complementary health practice for IBS, here’s what you need to know:
  • Herbal remedies. Herbal remedies are commonly used for IBS symptoms; however, much of the research on these remedies has been done in China. A review of clinical trials for 71 herbal remedies found limited evidence suggesting that a few of these herbal remedies might help improve IBS symptoms including abdominal pain, constipation, and diarrhea. However, the review emphasizes that the studies were generally of poor quality.
  • Peppermint oil. Peppermint oil is one herbal remedy often used to treat IBS for which there are mixed results. There is some evidence that enteric-coated peppermint oil capsules may be modestly effective in reducing several common symptoms of IBS—especially abdominal pain, bloating, and gas. Non-enteric coated forms of peppermint oil may cause or worsen heartburn symptoms, but otherwise appear to be generally safe.
  • Probiotics. Probiotics such as Bifidobacterium and Lactobacillus are live microorganisms that are similar to microorganisms normally found in the human digestive tract, and they have been associated with an improvement in IBS symptoms compared with placebo. Results of studies suggest probiotics may decrease some patients’ abdominal pain, bloating, and gas.
  • Acupuncture. While a few small studies have indicated that acupuncture has some positive effect on quality of life in people with IBS, reviews of the scientific literature have concluded that there is no convincing evidence to support the use of acupuncture for the treatment of IBS symptoms.
Tell all your health care providers about any complementary health practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
To learn more about managing symptoms of IBS, consult your doctor and a registered dietitian. sls