How is IBS Treated?

Jan 21, 2017 by

 

You can have me read this article to you instead of reading it yourself…

Or you can read it the old-fashioned way below…


Now that we have covered the symptoms and causes of IBS, it seems like the treatments for this syndrome should be pretty straightforward.  And the good news is that, for some people, this is true.  It is pretty straightforward.  Unfortunately, that is not the case for everyone.  And when it is not straightforward, attempting to treat IBS can become a frustrating and discouraging endeavor.

Identifying the Cause

As we already discussed, there are a variety of causes for IBS.  Because of this, the strategies for treatment are based in understanding (to the best of your ability) what is actually causing your IBS to occur.  If it is stress or anxiety related, this will lead to a much different strategy for treatment than for the people who seem to have some type of food ingredient sensitivity.

Unfortunately, there is no quick trick to identifying the cause of your symptoms.  It requires diligence and monitoring – identifying trends and triggers.  For instance, it may be helpful to keep a ‘mood and food diary’ that tracks your mental state and food consumption along with your symptoms.  This is a helpful way to identify if one or both of these are triggering your symptoms.

Treatments for Other Conditions

It is important to rule out any other conditions prior to attempting to treat IBS.  Small Intestinal Bacterial Overgrowth, which is discussed here, would be treated much differently than IBS.  But it can be a primary cause of IBS symptoms for some people.

If you think it is a possibility in your case, then you should also be evaluated for clinical depression or anxiety.  Treatment for these conditions can often make an enormous impact on the symptoms experienced from IBS.  And treatment for these conditions does not need to involve medication. Counseling and development of coping strategies can be just as helpful in many cases.

Dietary Changes

Diets focused on eliminating IBS are all the rage these days.  Some of these have been shown to help, while others have not.  Some are very difficult to follow and others are more straightforward.  They all carry risks, although for some, the risks probably outweigh the real benefits.

It can be confusing to have all of these possible options and difficult to identify which ones are most likely to actually help.  Most people stand to make money off of the diets that they are selling.  This makes it hard to find good guidance on how long to try something for, and how to understand if it is actually working.

Risks with Diet Changes

For the most part, the random cookbook on the shelf at the bookstore is not going to be based in solid evidence.  It also might not be very focused on your ability to maintain proper nutrition during your trial of this new diet.  And it may not clarify how to make changes in a step-by-step fashion so that you can identify which changes are working and which are not.

These diets are often referred to as restrictive diets, because they restrict what you are able to eat.  One of the greatest risks with these diets is that they will greatly restrict your nutritional intake.  In fact, it is not uncommon for people on a gluten-free or FODMAP diet to develop nutritional deficiencies. There is plenty of data on nutritional deficiencies in a group that must remain gluten-free to stay healthy –  those with Celiac disease.

Another common risk with these diets is that they actually lead to poorer health and weight gain.  When certain ingredients are removed from foods, they lose their expected flavor and consistency.  To make up for this, companies add in other ingredients, which often contain more fat and sugar.  Thus it is harder to not only eat a well-rounded diet, but also to keep weight and blood sugars under control.

Strategies with Diet Changes

As I already mentioned, it is important to be able to monitor the impact of a dietary change, so that you know whether or not it is working.  It is also important to first identify those changes that you believe are most likely to help you in your specific situation.

I will discuss the merits and strategies with these diets much more in an upcoming article.  If you believe that your IBS symptoms are triggered by foods, you may be interested in trying some of these diets.  Hop over to that page for some guidance on where to start and who you can turn to for help on starting and monitoring these changes.

Medications

The last real option left on the docket for the treatment of IBS symptoms is the use of medication.  If you have already evaluated your likely triggers and attempted to treat underlying causes (if any), then medications may be needed.

Symptom-Based Medications

The treatment options here are pretty intuitive based on the symptoms that are experienced.  Those with constipation will take medications that treat constipation, and those with diarrhea will take medications that treat diarrhea.  Of course, anyone who has done this will know that this is an oversimplified explanation!

Prescription medications, in general, work by treating the functional causes of diarrhea and constipation. On the other hand, medications that are often found over-the-counter (Miralax, docusate, Immodium), do not work in this way.  These products change the symptom only, without altering the cause of the symptom.

Prescription medications for IBS all have slightly different ways of working, so it might take trying a few different options and doses to find one that does work for you. Due to how common IBS appears to be, drug companies are currently researching many other medications.  Hopefully one or a few of these will provide relief for even more people down the road.

Psychiatric Medications

IBS symptoms may also be treated using the antidepressant class of medications.  Using antidepressants in this case is not because your doctor thinks you are depressed.  And it’s also not because he thinks it is all in your head!  Instead, these medications work directly on the cells in the intestine.  After all, the gut is actually a big bundle of nerves and has even been referred to as the body’s second brain.  So it makes sense that it might need some therapy of its own.

Many of the medications used for this purpose are used at lower doses than they would be for actual depression.  The research into which medications are best is still developing.  These drugs also have very different side effects, which must be weighed against the symptoms that you experience.  We do know that this treatment doesn’t work for everyone.  But when it does work, it can be a real game-changer.

These medications are typically used when there is no apparent trigger for your symptoms and dietary changes haven’t worked.  And, as you might imagine, they are also a particularly helpful option for people with IBS-M.  Since the medication does not treat constipation or diarrhea specifically, it may help to smooth out the gut’s mood swings.

This is an exciting time for research in this area, and we are learning more about how to improve symptoms every day!

 


Unfortunately, it is difficult to discuss each of the medications that are currently available for this condition within the scope of an online article.  At this point, there are many options on the market, and each one comes with its own side effects and risks.  A decision cannot be made without considering each person’s unique set of symptoms and other health issues.  But a simple breakdown of how IBS can and should be treated helps to clarify when and why certain options should be considered.

Interested in more information on IBS?

Next: What is the Difference Between IBS and IBD?

Or refer back to the IBS Info Hub.

 


Trivia and Terminology:

Restrictive Diets are those that limit the foods that are eaten in order to eliminate certain GI symptoms.  When used for a long time, they may also reduce nutritional intake.

FODMAP is an abbreviation that represents the different ‘rapidly fermentable carbohydrates’ that have been found to cause IBS symptoms in many people.  These are Fermentable – Oligosaccharides – Disaccharides – Monosaccrahides – Polyols.

Gluten is a protein found in wheat.  This means that any products that do not contain wheat (such as corn, soy, rice, nuts, and dairy) are, by nature, gluten-free.

 

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