Irritable Bowel Syndrome

What is Irritable Bowel Syndrome?

Irritable Bowel Syndrome (IBS) is quite common. Those afflicted with IBS experience symptoms such as constipation or diarrhea, pain, abdominal cramps, distension and gas. Symptoms vary in intensity and can be temporary or permanent. They usually occur after a meal and patients feel relief after a bowel movement. They are thought to result from a modification of the normal contraction of the intestinal muscles. IBS is often associated with a psychological component: emotion and stress have an impact on the colon. The patient's intestine appears to be hypersensitive to certain foods and to stress and to react more than the intestine of other people. As a result, the duration of digestion is affected and symptoms occur. The exact causes of IBS are still unknown.

IBS is associated with much discomfort but does not cause other intestinal complications (no increased risk of cancer for example). Anyone experiencing IBS symptoms along with fever, bleeding, unexplained weight loss or persistent and severe pain should consult a physician.

What are the treatment options?

IBS should be diagnosed by a physician to make sure that all other possible causes for the symptoms were excluded. The treatment's goal is to reduce and prevent symptoms. Unfortunately, not many drugs were shown to be effective.

Dietary changes

The best treatment to relieve symptoms of IBS remains changing the patient's diet and eating habits. The patient should keep a journal, writing down all food eaten each day. This can help identify which foods cause the symptoms. Once these foods are identified, the patient should try to avoid them as much as possible. Seeing a nutritionist for a more personalized approach is recommended. Here is a list of foods often associated with symptoms of IBS:

  • foods with caffeine, such as coffee, tea or chocolate;
  • foods with artificial sweeteners such as sorbitol and mannitol;
  • fatty foods;
  • spicy foods;
  • fried foods;
  • low-fibre foods;
  • foods containing grains, small pits or seeds;
  • cabbage, green cabbage, corn, legumes and onions;
  • oats;
  • prune juice;
  • oranges, lemons and grapefruits;
  • dairy products;
  • alcohol.

A few simple diet changes can have a major impact on IBS. Certain measures even appear to have a calming effect:

  • Eat more low-fat and fibre-rich foods, such as whole grain cereals and breads, grapes, dates, almonds, prunes and as a general rule, more fruits and vegetables. Be careful however! Increase your consumption slowly to prevent distension and diarrhea.
  • Drink plenty of water - between six and eight glasses a day.
  • Avoid large meals.
  • Eat at regular times.
  • Chew and eat slowly to avoid taking in air. Do not chew gum.

Stress management

We know that stress plays a major role in the appearance of symptoms. For this reason, patients should try to better manage their stress. Regular physical exercise (30 minutes per day) is recommended. Yoga, massage therapy, and meditation are other relaxation techniques that can be useful. Getting enough sleep is also important. For some, seeing a psychologist to help manage stress issues can be a good idea. For patients unsuccessful with other stress management methods, hypnosis and acupuncture may be another avenue to explore.

Useful drugs

Drugs are usually selected in function of the most severe symptom, either diarrhea or constipation. For those who suffer from constipation, the goal is to increase the rate of food transit across the intestine. Mild laxatives, such as lactulose and fibre supplements, are first-line agents.

For those who suffer from diarrhea, the treatment's goal is to slow the intestine's movements. Drugs called antidiarrheal, such as loperamide (Imodium™) are used. Antispasmodics, such as dicyclomine (Bentylol™) are sometimes recommended to relieve cramps. When a patient suffers from depression along with IBS, the physician may prescribe an antidepressant to help relieve anxiety and anguish and help relax the intestinal muscles.

Among herbal products, peppermint oil may offer some relief, especially in patients with diarrhea. It appears to reduce intestinal cramps. The recommended dosage is 0.2 to 0.4 mL, in capsules, three times a day, between meals.

Finally probiotics or lactic ferments are sometimes used. These products contain live inoffensive bacteria similar to those found in yogurt. They are used to try to balance the intestine's natural flora.

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