Alex Gazzola and Julie Thompson RD are guest-blogging for us during IBS Awareness Month! The co-authors of IBS: Dietary Advice to Calm Your Gut will be writing each week with tips and advice for management of IBS.
IBS Part Two: Treatments
Last week, in part 1 of this special four-part blog series to coincide with IBS Awareness Month, we looked at diagnosing IBS, and this week, before we look at diets next week, we’re considering treatments for IBS, which come in a number of forms, and many of which we cover extensively in our book, IBS: Dietary Advice to Calm Your Gut.
Once diagnosed with IBS, some general lifestyle advice your doctor may give you or talk to you about include:
Changes to your diet, such as adjusting fibre intake, along with other simple healthy eating tips, and other advice, based on whether you have constipation, diarrhoea or bloating as dominant symptoms. In many other cases, your doctor will refer you to a dietitian for more advanced dietary recommendations, such as the low-FODMAP diet, which should not be undertaken lightly, or without dietetic support. We will look at this more, next week.
Looking after your emotional wellbeing and personal relationships.
Making time for relaxation and leisure activities, and increasing your physical activity levels if they are low.
These might include:
These can help relax and soothe. This one is adapted with kind permission from Physiotherapy for Hyperventilation.
Lie comfortably on your back with a pillow under your head and knees.
Place one hand on your stomach, the other relaxed by your side.
Gently close your mouth and keep your jaw loose.
Breathe in gently through your nose, feeling your tummy rise and expand. The breath should be unforced and silent. Your upper chest should be relaxed and not moving; place your hand on it to check from time to time.
Breathe out lightly through your nose if possible, without pushing, keeping your stomach relaxed.
Relax and pause at the end of each breath out.
As you repeat this sequence be aware of any areas of tension in your body and concentrate on ‘letting go’, particularly jaw, neck, shoulders and hands. Practise as often as you can.
Doctors may prescribe certain drugs:
Buscopan is a first line medication, but also anti-spasmodic agents (Mebeverine, peppermint oil in capsules), Linaclotide (for constipation-dominant IBS), some probiotic supplements, and tricyclic anti-depressants (TCAs – if anti-spasmodic agents have failed).
Linaclotide (for constipation-dominant IBS), some probiotic supplements, avoidance of bulking agents / certain fibre sources.
Laxatives (but not lactulose), bulking agents, stool softeners, stimulants, osmotics, Linaclotide, tricyclic antidepressants (TCAs).
Anti-motility agents (Loperamide being the first choice), anti-spasmodic agents.
For other symptoms / problems
Antibiotics – for instance, for SIBO or H pylori infection.
Next week, we look at ‘Diet and Food’…
Alex Gazzola is a journalist and author who has been specialising in gut health and food sensitivities for over a decade. He writes widely for the national and international press, and is author of several books, including Coeliac Disease: What you need to know, and Living with Food Intolerance, both for Sheldon Press. Julie Thompson is a registered dietitian with a specialism in inflammatory and functional gut disorders and ‘free from’ diets for food intolerances and allergies. She is an adviser to the IBS Network and runs the Calm Gut Clinic.