Diet, Treatment & Lifestyle Changes
In most cases, you can successfully control mild symptoms of irritable bowel syndrome by learning to manage stress and making changes in your diet and lifestyle. Here are some tips that may be helpful:
Incorporate fiber into your diet, if possible.
When you have irritable bowel syndrome, dietary fiber can have mixed results. Although it helps reduce constipation, it can also make gas and cramping worse. The best approach is to gradually increase the amount of fiber in your diet over a period of weeks. Examples of foods that contain fiber are whole grains, fruits, vegetables and beans.
Avoid problem foods.
Common culprits include alcohol, chocolate, caffeinated beverages such as coffee and sodas, medications that contain caffeine, dairy products, and sugar-free sweeteners such as sorbitol or mannitol. If gas is a problem for you, foods that might make symptoms worse include beans, cabbage, cauliflower and broccoli.
Eat smaller meals.
If you have diarrhea, you may find that eating small, frequent meals makes you feel better.
Take care with dairy products.
If you are lactose intolerant you may need to eliminate dairy foods.
Drink plenty of liquids.
Try to drink plenty of fluids every day. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse. Carbonated drinks can produce gas.
Exercise helps to relieve depression and stress, stimulates normal contractions of your intestines, and helps you feel better about yourself.
Because it’s not clear what causes irritable bowel syndrome, treatment focuses on the relief of symptoms so that you can live as normally as possible. But if your problems are moderate or severe, you may need to do more. Your doctor may suggest:
Taking fiber supplements, such as psyllium (Metamucil) or methylcellulose (Citrucel), with fluids may help control constipation.
Over-the-counter medications, such as loperamide (Imodium), can help control diarrhea.
Some people need medications that affect certain activities of the autonomic nervous system (anticholinergics) to relieve painful bowel spasms. These may be helpful for people who have bouts of diarrhea, but can worsen constipation.
If your symptoms include pain or depression, your doctor may recommend an antidepressant. These medications help relieve depression as well as inhibit the activity of neurons that control the intestines.
It’s unclear what role, if any, antibiotics might play in treating IBS. Some people whose symptoms are due to an overgrowth of bacteria in their intestines may benefit from antibiotic treatment. But more research is needed.
If stress tends to worsen your symptoms you may benefit from counseling or other ways to reduce your stress level.
Medication specifically for IBS
Two medications are currently approved for specific cases of IBS:
- Alosetron (Lotronex). The Food and Drug Administration (FDA) has approved the use of alosetron- only with restrictions. The drug can be prescribed only by doctors enrolled in a special program and is intended for severe cases of diarrhea-predominant IBS in women who haven’t responded to other treatments.
- Lubiprostone (Amitiza). Lubiprostone is approved for adult women and men who have IBS with constipation.