IBS: Your Guide to Tailoring Treatment

Written by Ann Pietrangelo & Tricia Kinman | Published on September 29, 2014
Medically Reviewed by Kenneth R. Hirsch, MD on September 29, 2014

IBS: Your Guide to Tailoring Treatment

Just because there isn't a single definitive way to treat IBS doesn't mean it can’t be treated. Lifestyle changes can make a difference and your doctor can help you work through other options.

A key IBS symptom called chronic idiopathic constipation means that you have infrequent bowel movements without any known specific cause of constipation being present.

Diet

Certain foods can trigger symptoms, so keep a food journal to help pinpoint the culprits. 

Some common problem foods include dairy products, alcohol, and foods that contain caffeine or non-sugar sweeteners. Foods that can cause gas include:

  • broccoli
  • cauliflower
  • beans
  • cabbage
  • high-fat foods

Fiber can be tricky. It helps relieve constipation, but can increase gas and cramping. Experiment with foods that contain fiber and adjust according to your current symptoms. Keep in mind that foods with psyllium (a type of fiber) are more effective than bran (another type of fiber) for relief of IBS symptoms. Keep meal sizes small and be sure to drink plenty of fluids.

Exercise

Exercise aids in digestion and relieves stress. Tai chi and yoga may help you relax and manage pain.

Medication

Ask your doctor which prescription or over-the-counter medications may relieve your symptoms. Medications can interact with each other, so keep your doctor informed about all your medication use.

Don't rely too heavily on over-the-counter anti-diarrheal medications and laxatives. If you use them, use the lowest dose that offers relief, and use them sparingly.

Anticholinergics and antispasmodics are said to relieve bowel spasms and the abdominal pain and discomfort that occurs after meals. Antidepressants in low doses can inhibit pain signals that fire between your gut and your brain. Anti-anxiety drugs can help relieve emotional stress.

Some doctors prescribe antibiotics for people who have an overgrowth of the normal bacteria that grows in the gut. According to the American College of Gastroenterology (ACG), recent research has shown that rifaxamin, a type of antibiotic, is moderately effective in people who have IBS and diarrhea.

Probiotics

According to the ACG, there is growing evidence that probiotics such as Bifidobacterium and Lactobacillus can relieve bloating, gas, and abdominal pain in some patients with IBS. Probiotics are available in dietary powder or tablet form, and can be found in many foods, such as yogurt and sauerkraut. Be careful not to confuse these with prebiotics or synbiotics. Ask your doctor which probiotics may work, and how much you should take. 

Complementary and Alternative Therapies

IBS varies from person to person, and so do symptoms. While some people may benefit from the following therapies, supporting evidence is lacking in most cases. However, depending on your symptoms and your level of stress, some of these techniques may be worth trying:

  • Acupuncture can be used to relax muscle spasms, which may relieve back pain and improve quality of life.
  • Herbal remedies may improve constipation, diarrhea, and abdominal pain, but there isn’t enough research to draw a conclusion.
  • Meditation, massage, and hypnotherapy may help relax your muscles, reduce pain, and improve quality of life.
  • Peppermint oil is sometimes used to treat gas, bloating, and pain, but studies show mixed results.
  • Relaxation therapy, including deep breathing, abdominal breathing, progressive muscle relaxation, and visualization exercises can help reduce stress and fatigue and improve mood.

When using complementary therapies, make sure you seek out a qualified practitioner and inform your doctor.

Psychological Support

IBS can seriously impact your quality of life. According to the ACG, recent studies suggest that psychological therapy can help improve IBS. Seek out a qualified therapist if you have anxiety or depression. You may feel alone, but you're not the only one with IBS. Support groups can be a great way to exchange information and feel less isolated. Your doctor or local hospital can give you information about local support groups.

On the Road

Taking a trip with IBS can be an anxiety-inducing proposition. However, a little advance planning can make all the difference.

  • Driving may provide more flexibility than flying. Just be sure to allow enough driving time so you don't add unnecessary stress.
  • Do your homework before a long drive. Map out the rest stops in advance.
  • If you're flying, choose an aisle seat close to the bathroom.
  • In hotels, motels, or campsites, check beforehand to make sure you don't have to share a bathroom.
  • Avoid foods that trigger attacks while traveling.
  • Carry a small bag or backpack. Include a change of clothes, your medications, water, and extra tissues.
  • Keep your physician's name and contact information handy.
  • Be flexible with your plans. Have alternatives in mind so that if things don't work out, you don't have to miss out on fun entirely.

Special Tips for Women

Pregnancy

If you're pregnant, you may not want to take medications. Make sure your gynecologist knows that you have IBS. Pay special attention to foods that cause IBS symptoms and adjust your diet accordingly. Relaxation therapies may be particularly helpful during pregnancy.

Menstrual Cycle

Some women find that their IBS symptoms change according to their menstrual cycle. Here are some common symptoms and possible solutions:

  • constipation: Use bulking agents like fiber or psyllium laxatives (bran laxatives are less effective).
  • diarrhea: Anti-diarrheal medications may help.
  • gas and bloating: Avoid common food triggers like beans, bananas, dairy products, raw fruits and vegetables, pretzels, fructose, and sorbitol.

Remember to eat small meals and drink plenty of water. Mild exercise can help with digestion and sleep. Consult with your doctor if you experience pain and discomfort during intercourse.

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