by James Hubbard, M.D., M.P.H.
I have been treating irritable bowel syndrome, sometimes called spastic colon, since I began practice in the 1980s. I saw a lot of it when I had a full-time family practice.
Several new treatment drugs have been developed and removed from the market within the past few years, due to bad side effects. An article in the British Medical Journal shows that really, much has not changed since the 1980s.
The researchers analyzed as many past treatment studies as they could scrape up and found that what we’ve been doing does, in fact, work many times. But much more needs to be done.
What is irritable bowel syndrome?
We think the IBS patient’s colon is more sensitive to stress and food. We don’t know the cause. Symptoms are intermittent and include chronic abdominal bloating and cramping, along with constipation or diarrhea, which can alternate. As many as 20 percent of the United States may suffer–women more than men.
Lifestyle treatments for IBS
Your first step is to see your doctor to rule out things that cause similar symptoms. Next, see if you can relate the symptoms to eating large meals or foods such as milk, spicy or fatty foods, caffeine, or alcohol. If so, avoidance is key. Talk to your doctor about medicines that might trigger it. Anxiety or stress is a common trigger, and relaxation techniques may help.
Other treatments for IBS
Now for the BMJ article. Reviewing past studies, they looked at the effectiveness of three common treatments. (Notice that placebo–the fake treatment–had a significant effect in all three).
- Fiber. Specifically, psyllium (ispaghula husks in Britain, where the study was done) helped 48 percent of patients and placebo helped 36 percent, giving psyllium a 1 in 6 chance of helping. I didn’t see dosage, but the usual is 1 tablespoon mixed in a full glass of liquids one to three times a day. Wheat fiber did not help.
- Antispasmotics. They looked at many with which I was not familiar (British meds). Your doctor will help you chose. Overall, there was a 1 in 5 chance they helped.
- Peppermint oil. I knew it is supposed to help some digestive disorders, but I’ve never used it for IBS. The researchers found it helped 65 percent compared to placebo’s 35 percent. One in 2.5 patients saw benefit overall.A recommended dosage, at a University of Maryland Medical Center Web site, is 2 enteric coated capsules three times a day between meals. Don’t take if you have GERD (recurrent heartburn) or are pregnant.
The article did not look into whether a combination of treatments works better. I’m guessing it does. Always talk to your doctor for individual advice. Many people will benefit from these lifestyle changes and old treatments, at least until new, more expensive ones come along.
Has anyone found relief from these or other remedies?