22/01/2016
Want to know more about Irritable Bowel Syndrome...?
Irritable bowel syndrome (IBS) is a common, long-term condition of the digestive system. It can cause bouts of stomach cramps, bloating, diarrhoea and/or constipation.
The symptoms vary between individuals and affect some people more severely than others. They tend to come and go in periods lasting a few days to a few months at a time, often during times of stress or after eating certain foods.
Tips to help manage IBS....
IBS-friendly diet...
Changing your diet will play an important part in controlling your symptoms of IBS. However, there is no "one size fits all" diet for people with the condition. The diet that works best for you will depend on your symptoms and how you react to different foods.
It may be helpful to keep a food diary and record whether certain foods make your symptoms better or worse. You can then avoid foods that trigger your symptoms.
Fibre
People with IBS are often advised to modify the amount of fibre in their diet. There are two main types of fibre: soluble fibre (which the body can digest) and insoluble fibre (which the body cannot digest).
Foods that contain soluble fibre include:
oats
barley
rye
fruit – such as bananas and apples
root vegetables – such as carrots and potatoes
golden linseeds
Foods that contain insoluble fibre include:
wholegrain bread
bran
cereals
nuts and seeds (except golden linseeds)
If you have diarrhoea, you may find it helps to cut down on the insoluble fibre you eat. It may also help to avoid the skin, pith and pips from fruit and vegetables.
If you have constipation, increasing the amount of soluble fibre in your diet and the amount of water you drink can help.
Low FODMAP diet
If you experience persistent or frequent bloating, a special diet called the low FODMAP diet can be effective.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These are types of carbohydrates that aren’t easily broken down and absorbed by the gut. This means they start to ferment in the gut relatively quickly, and the gases released during this process can lead to bloating.
A low FODMAP diet essentially involves restricting your intake of various foods that are high in FODMAPs, such as some fruits and vegetables, animal milk, wheat products and beans.
Your IBS symptoms may also improve by:
having regular meals and taking your time when eating
not missing meals or leaving long gaps between eating
drinking at least eight cups of fluid a day – particularly water and other non-caffeinated drinks, such as herbal tea
restricting your tea and coffee intake to a maximum of three cups a day
reducing the amount of alcohol and fizzy drinks you drink
reducing your intake of resistant starch (starch that resists digestion in the small intestine and reaches the large intestine intact), which is often found in processed or re-cooked foods
limiting fresh fruit to three portions a day – a suitable portion would be half a grapefruit or an apple
if you have diarrhoea, avoiding sorbitol, an artificial sweetener found in sugar-free sweets, including chewing gum and drinks, and in some diabetic and slimming products
if you have wind (flatulence) and bloating, it may help to eat oats (such as oat-based breakfast cereal or porridge) and linseeds (up to one tablespoon a day)
Exercise
Many people find that exercise helps to relieve the symptoms of IBS.
Aim to do a minimum of 150 minutes of moderate-intensity aerobic activity, such as cycling or fast walking, every week.
The exercise should be strenuous enough to increase your heart and breathing rates.
Reducing stress
Reducing your stress levels may also reduce the frequency and severity of your IBS symptoms. Some ways to help relieve stress include:
relaxation techniques – such as meditation or breathing exercises
physical activities – such as yoga, pilates or tai chi
regular exercise – such as walking, running or swimming
Probiotics
Probiotics are dietary supplements that product manufacturers claim can help improve digestive health. They contain so-called "friendly bacteria" that can supposedly restore the natural balance of your gut bacteria when it has been disrupted.
Some people find taking probiotics regularly helps to relieve the symptoms of IBS. However, there is a little evidence to support this, and it is unclear exactly how much of a benefit probiotics offer and which types are most effective.
If you want to try a probiotic product, you should take it for at least four weeks to see if your symptoms improve.
Medication
A number of different medications can be used to help treat IBS, including:
Antispasmodics
Antispasmodics work by helping to relax the muscles in your digestive system. Examples of antispasmodic medicines include mebeverine and therapeutic peppermint oil.
Side effects associated with antispasmodics are rare. However, people taking peppermint oil may have occasional heartburn and irritation on the skin around their bottom.
Laxatives
Bulk-forming laxatives are usually recommended for people with IBS-related constipation. They make your stools softer, which means they are easier to pass.
It's important to drink plenty of fluids while using a bulk-forming laxative. This will help prevent the laxative from causing an obstruction in your digestive system.
Start on a low dose and then, if necessary, increase it every few days until one or two soft stools are produced every one or two days. Do not take a bulk-forming laxative just before you go to bed.
Side effects associated with taking laxatives can include bloating and wind. However, if you increase your dose gradually, you should have few, if any, side effects.
Antimotility medicines
The antimotility medicine loperamide is usually recommended for IBS-related diarrhoea.
Loperamide works by slowing contractions of muscles in the bowel, which slows down the speed at which food passes through your digestive system. This allows more time for your stools to harden and solidify.
Side effects of loperamide can include stomach cramps and bloating, dizziness, drowsiness and rashes.
Antidepressants
Two types of antidepressants are used to treat IBS – tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).
TCAs, such as amitriptyline, are usually recommended when antispasmodic medicines have not been able to control the symptoms of pain and cramping. They work by preventing signals being sent to and from the nerves in your digestive system.
However, TCAs will only start to provide relief after three to four weeks, as your body gets used to the medication.
Side effects of TCAs can include a dry mouth, constipation, blurred vision and drowsiness. These side effects should improve within a few days of starting the medication. Tell your GP if the side effects become a problem – they may prescribe another type of antidepressant.
SSRIs are an alternative type of antidepressant. Examples of SSRIs that are used to treat IBS include citalopram, fluoxetine and paroxetine.
Common side effects of SSRIs include blurred vision, dizziness and diarrhoea or constipation.
Psychological treatments
If your IBS symptoms are still causing problems after 12 months of treatment, your GP may refer you for a type of therapy known as a psychological intervention.
There are several different types of psychological therapy. They all involve teaching you techniques to help you control your condition better, and there is good evidence to suggest they may help some people with IBS.
Psychological treatments that may be offered to people with IBS include:
psychotherapy – a type of therapy that involves talking to a trained therapist to help you to look deeper into your problems and worries
cognitive behavioural therapy (CBT) – a type of psychotherapy that involves examining how beliefs and thoughts are linked to behaviour and feelings, and teaches ways to alter your behaviour and way of thinking to help you cope with your situation
hypnotherapy – where hypnosis is used to change your unconscious mind's attitude towards your symptoms
Access to public toilets
Being able to easily access public toilets is important if you have sudden, urgent bouts of diarrhoea. Two schemes that can help are:
the IBS Network – which provides members with a Can't Wait Card to help them gain immediate access to toilet facilities in offices, stores and other UK businesses
the National Key Scheme (NKS) by Disability Rights UK – which provides access to the thousands of locked disabled toilets around the country
For help and advice, pop in to see us at Reid's Pharmacy!