The term IBS cure is subjective and the condition itself is very personal. IBS is typically managed, not cured. The most common way to manage IBS symptoms is to manage one’s diet. It is helpful to keep track of food intake and any associated symptoms or flareups for a timeframe. At the start, it may make the most sense to start with a limited set of food items and slowly expand the list as time goes on. Common food and drinks that can cause discomfort are listed below:
People with lactose intolerance and fructose malabsorption need to pay additional care to rule out causative foods. Elimination diets to remove dairy or high FODMAPs (fermentable oligo-, di-, monosaccharides, and polyols) are other options to explore. Each person’s journey tends to be unique with IBS and a combination of remedies may work best as an “IBS cure”. Check out our overview on IBS.
The personal journey towards an IBS cure
When seeking relief from the symptoms of irritable bowel syndrome (IBS), keeping track of your food intake and associated symptoms is crucial. For a period of 4-6 weeks, it is recommended to start with a limited selection of foods and gradually expand the list over time. For instance, in the first week, you could include steamed vegetables, rice, and a fruit.
To manage IBS effectively, it is important to be aware of common food and drinks that can cause discomfort. These include gas-producing vegetables, high-fat foods, carbonated beverages, artificial sweeteners, caffeine, and alcohol. Individuals with lactose intolerance and fructose malabsorption should pay extra attention to identifying the foods that trigger their symptoms. Exploring elimination diets to remove dairy or high FODMAPs (fermentable oligo-, di-, monosaccharides, and polyols) is also an option worth considering. It is essential to acknowledge that each person’s journey with IBS is unique, and a combination of remedies may provide the best “IBS cure.” For more information on IBS, refer to our comprehensive overview.
IBS tests and diagnosis
The diagnosis of IBS is typically based on a comprehensive medical history, physical examination, and tests aimed at ruling out other conditions like celiac disease and inflammatory bowel disease (IBD). Once other conditions are ruled out, your healthcare provider may use the Rome criteria – these criteria involve assessing abdominal pain or discomfort occurring at least once a week in the past three months, along with at least two of the following: pain related to bowel movements, changes in bowel movement frequency, or changes in stool consistency. The IBS may then be categorized into four types for treatment purposes based on predominant symptoms: constipation-predominant, diarrhea-predominant, mixed, or unclassified.
Your provider will also evaluate if you have any additional symptoms that could suggest a more serious condition, such as:
If you experience these symptoms or if initial IBS treatment proves ineffective, additional tests may be necessary. These tests may include:
Laboratory tests may involve:
These diagnostic procedures and tests help in determining the presence of IBS and ruling out other potential causes of your symptoms.
Treatment options
Managing and alleviating symptoms is the primary focus in treating IBS, aiming for a better quality of life. Depending on the severity of your symptoms, treatment options may vary. For mild symptoms, implementing changes in your diet and lifestyle, as well as stress management, can often be effective. Consider the following:
To assist with dietary adjustments, consulting a registered dietitian can provide valuable guidance. If your symptoms are moderate or severe, counseling may be recommended, particularly if you have depression or stress exacerbates your symptoms. Based on your specific symptoms, medications may be prescribed, including:
Medications specifically approved for certain cases of IBS include:
Potential future treatments being investigated for IBS include fecal microbiota transplantation (FMT). FMT involves introducing processed stool from a healthy individual into the colon of an IBS patient to restore a healthy gut microbiome. Clinical trials are currently underway to explore this option further.
Exploring the role of fiber
Dietary fiber has long been recognized as beneficial for various gastrointestinal conditions, including IBS. A deficiency in dietary fiber intake is considered a primary cause of IBS. Increasing the amount of dietary fiber consumed is a common recommendation for IBS patients.
Dietary fiber can be divided into two types: soluble and insoluble. Soluble fiber dissolves in water and can be further categorized as short-chain or long-chain carbohydrates, fermentable or non-fermentable. Short-chain, soluble, and highly fermentable fiber, such as oligosaccharides, can lead to excessive gas production, resulting in symptoms like abdominal pain, bloating, and flatulence. In contrast, long-chain, soluble, and moderately fermentable fiber, like psyllium, produces less gas and does not cause excessive symptoms.
Physicians often advise IBS patients to increase their daily dietary fiber intake to 20-35 grams to regulate bowel movements and reduce abdominal pain. Supplementation with long-chain, soluble, and moderately fermentable fiber, such as psyllium, has shown improvements in overall IBS symptoms. Additionally, consuming smaller, more frequent meals instead of the traditional three main meals can alleviate stress on the digestive system.
FODMAPs, which are short-chain carbohydrates poorly absorbed in the small intestine, have been shown to significantly improve symptoms when restricted in the diet. A low-FODMAP diet, which globally trims these carbohydrates, can be helpful for individuals with IBS, particularly when other dietary and lifestyle measures have been unsuccessful. However, it is crucial to ensure a proper diagnosis of IBS before pursuing this diet, as it may lead to the misdiagnosis of other conditions like celiac disease.
Physical activity has also demonstrated potential benefits for IBS. Regular exercise has been shown to improve IBS symptoms, including severity and constipation. Therefore, it is recommended that all IBS patients engage in regular physical activity, as advised by the British Society of Gastroenterology guidelines.
Various medications can be considered for symptom management. Antispasmodics, such as dicyclomine, can provide relief for cramps and diarrhea. Laxatives, like polyethylene glycol, sorbitol, and lactulose, can be helpful for those who do not.
Probiotics
In addition, your healthcare provider might suggest incorporating probiotics into your treatment plan. Probiotics are live microorganisms, primarily bacteria, that resemble the beneficial microorganisms naturally present in your digestive system. While the use of probiotics for treating IBS is still being researched, they may offer potential benefits.
To ensure safety, it’s important to consult with your doctor before starting probiotics or any other complementary or alternative medical approaches. If your doctor recommends probiotics, have a discussion about the appropriate dosage and duration of use.
Mental health therapies
In addition to medical treatments, your healthcare provider may suggest mental health therapies as part of your IBS management. These therapies aim to improve your IBS symptoms by addressing the psychological factors associated with the condition. Some of the commonly used mental health therapies for IBS include:
These mental health therapies can complement medical treatments and provide a holistic approach to managing IBS. Discuss with your healthcare provider to determine which therapy may be most suitable for your specific needs.
References:
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