Saturday, September 19, 2020

Irritable Bowel Syndrome Ultimate Guide to Treatment


What is IBS?

Irritable bowel syndrome (IBS) is a disorder that causes the muscles in the large intestine to contract slower or faster than is normal, resulting in unpleasant gastrointestinal symptoms. Approximately 58 million people in the United States are affected by irritable bowel syndrome. It is the most common gastrointestinal condition responsible for people visiting a gastroenterologist, which is a doctor who specializes in the digestive system. Around one in six Americans experience symptoms of irritable bowel syndrome at some point in their lives.

Irritable bowel syndrome fortunately does not cause permanent intestinal damage. However, it can  cause serious issues for some people. Unlike more severe intestinal disorders, such as Crohn’s disease, ulcerative colitis and irritable bowel disease, people with irritable bowel syndrome do not have an abnormal structure of their bowels. These diseases cause intestinal inflammation and increase the risk of colorectal cancer, but irritable bowel syndrome does not. People with serious cases of irritable bowel syndrome may have difficultly traveling or experience significant discomfort that interferes with work or their social lives.

Types of Irritable Bowel Syndrome

There are three different classifications of IBS, based on the affect on the colon and the overall elimination process. They are:

Diarrhea Predominant IBS– this form is characterized by mainly loose stools. The individual may have an urgent and often uncontrollable urge to relieve themselves and the output is watery and without shape. This type can lead to dehydration, due to a continuous loss of liquid.

Constipation Predominant IBS- consists of infrequent or hard to pass stools, which may cause pain, gas, bloating-especially after meals, headache, exhaustion and acid reflux.

Alternating IBS occurs when an individual experiences both diarrhea and constipation in alternating cycles. This can be one of the most physically taxing and hard to treat types of IBS because of the unpredictability of the symptoms.

Similar Disorders

Not to be confused with Irritable Bowel Syndrome, there are other, sometimes similar bowel disorders. Amongst them are:

Crohn’s Disease is an inflammatory disease of the bowel that is thought to be autoimmune in nature, meaning that the body mistakenly attacks healthy tissue in the colon. Crohn’s can be severely debilitating and can affect any and every part of the digestive tract, from the mouth to the organs of elimination. The illness has a hereditary component, but a malfunctioning immune system and environmental pathogens are highly implicated in the development of Crohn’s Disease. Symptoms vary based on the individual and the severity of the illness and include abdominal pain, bloody stools, ulcers, scarring of the bowel wall, weight loss, skin abnormalities, exhaustion and arthritis pain.

Celiac Disease is an autoimmune disorder where the body attacks the lining of the small intestines. Specifically, an acute sensitivity to gluten (found in wheat, barley and rye) causes the immune system to attacks the villi which line the small intestine and are responsible for nutrient absorption. Celiac Disease is more commonly found in individuals with other autoimmune disorders and illnesses, such as Lupus, Rheumatoid Arthritis and Thyroid Disease. Symptoms include malnourishment, diarrhea or constipation, gas and bloating, bloody or fatty stools and depression.

Colitis is inflammation and swelling of the large intestine. An extremely painful disease, Colitis can be triggered by a number of things, including food poisoning, a virus, bacteria, parasitic infestation, lack of blood flow to the colon and prior radiation treatment. Individuals with Colitis may feel the constant need to empty their bowels and may also experience bloody stools. Other symptoms include abdominal pain, fever, chills diarrhea and dehydration.

Leaky Gut Syndrome is a new diagnosis that not all mainstream physicians acknowledge. Essentially, in patients with Leaky Gut, there is damage to the lining of the intestines, which allows matter to escape into the bloodstream causing a variety of symptoms. Substances that are able to pass through the lining include particles of undigested food, toxins and bacteria and undigested fat and protein. As it is not normal for these substances to be found in the body, the immune system reacts to them as foreign invaders and attacks, prompting an inflammatory response. Over time, this ongoing inflammation can cause mild to severe symptoms, including autoimmune response, skin rash, joint pain, gas and bloating, food sensitivities and severe pain.

How Does the Colon Function?

To fully understand this condition, it is important to have a working knowledge about the colon and its functions. This will allow you to readily identify abnormal symptoms and seek medical assistance.

The colon is also known as the “large intestine” and is attached to the end of the small intestines. While the small intestines can measure up to 23 feet in length, the colon is much shorter at approximately five feet. Muscular in nature, the colon pushes digested food towards the rectum for elimination. The colon is the last stop for digested food before it is excreted and works to remove water, salt and nutrients that will be used in the body. The remaining matter is what is known as stool.

Causes of Irritable Bowel Syndrom

While the exact cause of IBS is not known in the mainstream medical community, there are some indicators of what can contribute to development of the disease, including:

Post-infectious IBS refers to symptoms that manifest after a recognized colon infection, especially a severe case of bacterial gastroenteritisis in the form of E-coli, Shigella and Salmonella poisoning.  Statistics are varied, with a reported 4%-32% of intestinal infections progressing to IBS. In many of these cases, the immune system attacks the mucous lining of the intestines causing inflammation and allows food and waste particles to escape the colon into the body. After resolving the initial infection, some patients are able to treat the resulting IBS symptoms effectively in a short period of time, while others experience long term discomfort over a period of years. Post-infectious IBS is more prevalent in women than men and has been found more frequently in those suffering from a high level of stress.

Bacterial overgrowth is another possible cause of Irritable Bowel Syndrome, which in a study conducted by Ceders-Sinai Medical Center, showed that 78% of patients had excessive bacterial overgrowth. The digestive tract is host to millions of bacteria which maintain a delicate ecosystem and help to regulate digestion and food absorption. There are two types of bacteria- good and bad bacteria. In its optimal state, the good bacterium keeps the bad from taking over and causing problems. In the case of bacterial overgrowth, this balance has been upset. This can be due to a number of reasons, including:

  • Previous use of antibiotics, as they eradicate both good and bad gut bacteria indiscriminately
  • Chronic low levels of stomach acid
  • Taking immune suppressing drugs
  • Parasitic infections
  • Drinking contaminated water
  • Food intolerances
  • Excessive alcohol consumption
  • Slow moving bowels

Stress has been indicated as a factor in IBS. Many of the body’s hormones and immune function is centered in and affect the gut, thus stress can have quite an impact on bowel function. One poll showed that approximately 70% of people realized tangible changes in their bowel function when they are stressed. Things such as relationship problems, family issues, loss of a loved one and work pressure can all bring about the symptoms of IBS.

Serotonin levels in the brain which affect mood have been shown to impact IBS symptoms and the severity thereof. The hormones of the brain and intestinal function is linked in what some call the brain/gut axis, meaning that the state of one interacts with and affects the other at some point. Feelings of depression, anxiety and hyperactivity can have a direct impact on the colon inducing cramping, gas, diarrhea, constipation and sluggish elimination.

Female reproductive hormones have also been seen to influence the severity of IBS symptoms. It is not necessarily the estrogen and progesterone released during the ovulation cycle that has an impact, but it has been observed that during a woman’s menstrual period, she is more likely to experience an increased number of bowel movements. For those that suffer from existing bowel dysfunction, this can be a highly uncomfortable time of month. This, in addition to the fact that more women than men suffer from depression-which is also a factor in IBS, may account for the 2:1 ratio of women versus men with this condition.

Blastocystitis is the condition in which single cell microscopic parasites called B. hominis are present in the digestive tract and have multiplied greatly, causing the symptoms of IBS. Often found in people with no symptoms, B. homonis parasites can exist in the bowels without irritating the individual. However, it is thought that when they are combined with other parasites or infectious agents that IBS symptoms tend to occur. Some of the most common symptoms of Blastocyctitis including diarrhea, bloating, cramps, flatulence, and anal itching. It is thought that B. hominis infections are the result of poor bathroom hygiene and possibly, oral/fecal contamination.

Risk Factors

Women and younger people are at greater risk for developing irritable bowel syndrome. More than eight out of 10 people in the United States who have irritable bowel syndrome are women, according to the American College of Gastroenterology.

Teenagers and young adults are frequently victims of irritable bowel syndrome. More than 50 percent of irritable bowel syndrome sufferers developed the condition prior to turning 35 years old. However, people older than 35 years of age can develop irritable bowel syndrome. Stress is often a key factor in development of irritable bowel syndrome among older adults.

People whose family members suffer from irritable bowel syndrome may be at an increased risk. Doctors do not know if genetics play a role in irritable bowel syndrome or if a family’s environment is a factor, or if both can increase the risk for irritable bowel syndrome.

However, it has been observed that people with a first-degree relative with irritable bowel syndrome is at a higher risk for getting condition as well.


Irritable bowel syndrome causes a range of gastrointestinal symptoms that most people find tolerable with treatment and lifestyle modifications. Symptoms can be mild to severe. Mild symptoms may  sometimes interfere with daily activities but do not happen frequently. Moderate symptoms typically happen more often, are more intense and are more likely to interfere with normal activities. Only some people experience severe, disabling symptoms that are intense. Irritable bowel syndrome can be a serious problem for people with severe symptoms.

Abdominal pain, discomfort, bloating, gas and flatulence are the most common symptoms among people with irritable bowel syndrome. People often feel an urgency to defecate. Morning rushes to the bathroom are common. These people may also have to use the bathroom several times after waking up and frequently during breakfast or after eating. Other common problems include changes in bowel movements and loss of appetite.

Abdominal pain generally follows certain patterns in people with irritable bowel syndrome and is often linked to bowel movements. Once a person has a bowel movement, the pain in their abdomen along with other symptoms may go away. Pain can also begin alongside noticeable changes in the frequency of bowel movements or changes in the appearance of stools.

Changes in elimination patterns or stool appearance can also be linked to constipation or diarrhea in people with irritable bowel syndrome. When a person with irritable bowel syndrome is constipated, their symptoms may include:

  • Cramping during bowel movements
  • Dry, hard stools
  • Experiencing three or fewer bowel movements within one week
  • Inability to pass stools or only being able to pass a small amount
  • Small, pellet-like stools
  • Strain during bowel bowel movements
  • A person with irritable bowel syndrome experiencing diarrhea may exhibit symptoms, such as:
  • Feeling of urgency to have a bowel movement
  • Having three or more eliminations in one day
  • Ribbony stools
  • Watery stools

Symptoms often occur following meals. Some irritable bowel syndrome sufferers may present with symptoms of both constipation and diarrhea. Other people may alternate between the two or experience only constipation or diarrhea.

Other symptoms of irritable bowel syndrome include a clear or whitish mucus in stools or the feeling that a person has not completed their bowel movements. However, symptoms vary by individual. Most people’s symptoms are mild, though they may worsen overtime even if the symptoms disappear for a brief time.

Irritable bowel syndrome is not a disease, but it is a chronic disorder. This means that symptoms can come and go but a person may have to deal with the symptoms recurrence for years. The symptoms of irritable bowel syndrome may have other causes. People are more likely to have irritable bowel syndrome if their symptoms last for more than six months initially and they experienced symptoms at least three days per month during the previous three months.

Many people suffering from irritable bowel syndrome also experience psychological problems. As many as 60 percent of people with irritable bowel syndrome have psychological symptoms, such as  depression and anxiety. The brains of people with irritable bowel syndrome and psychological symptoms are often low in the neurotransmitter serotonin, which plays a role in mood.

Irritable bowel syndrome may interfere with the body’s ability to absorb nutrients, leading to symptoms of malnutrition. Not everyone who is malnourished experiences issues, but common symptoms include dizziness, tiredness and weight loss.


Symptoms of irritable bowel syndrome are inconsistent. Due to the inconsistency and because there are no characteristically abnormal tests for irritable bowel syndrome, diagnosing the condition is difficult. Doctors review peoples’ medical histories and perform physical examinations when determining if irritable bowel syndrome is the cause behind their patients’ distress. The most important symptoms doctors consider when irritable bowel syndrome is suspected are abdominal discomfort or abdominal pain that has lasted a minimum of 12 weeks. The 12 weeks do not need to be consecutive.

Doctors also look for two of the following symptoms to diagnose irritable bowel syndrome:

  • Abdominal distension
  • Feeling as if one cannot completely empty their bowels
  • More or less frequent bowel movements
  • Mucus in stools
  • Straining during elimination
  • Urgency to defecate
  • Change in stool consistency, such as normal stools one day and then hard or loose stools another day

Rome Criteria

Another method for diagnosing irritable bowel syndrome is known as the Rome criteria. A group of investigators of gastrointestinal diseases from around the world met in 1992 in Rome to determine a criteria for diagnosing irritable bowel syndrome. This became known as the Rome criteria. It was modified in 1996 and then again in 2006. The original criteria is called Rome I. The 1996 version is the Rome II criteria and the 2006 version is called Rome III.

Some doctors may use Rome I or II, but Rome III criteria is more commonly applied. Rome III criteria states that patients must have abdominal discomfort, not pain, a minimum of one time each week for at least two months. Patients must also present with two out of three other features to be diagnosed with irritable bowel syndrome. The additional features include:

  • Change in the form of stools
  • Feeling of relief after passing stools
  • Increased or decreased frequency of bowel movements

The Rome III criteria does not take into account symptoms that may indicate a problem other than irritable bowel syndrome. These include pain or discomfort in the upper abdomen, more frequent flatulence and abdominal distension.

The Rome criteria also states that there must not be evidence of other conditions that could cause symptoms of abdominal discomfort when diagnosing irritable bowel syndrome. These alternate causes include obstructions, tumors, inflammation or a metabolic cause.


Irritable bowel syndrome may be linked to a lactose intolerance. Lactose is a sugar found in dairy products. Encouraging patients to abstain from eating dairy is one way to determine if a lactase deficiency is causing symptoms. Lactase is an enzyme the body uses to digest lactose. A deficiency in this enzyme results in difficulties digesting lactose, which could lead to symptoms similar to those caused by irritable bowel syndrome. Lactase deficiency is also called lactose intolerance or milk intolerance.

Doctors may ask patients to avoid eating any lactose-containing foods for two weeks to see if this resolves or lessens symptoms. Doctors may also use a breath test to diagnose a lactase deficiency.

Diagnostic Tests

Diagnosing irritable bowel syndrome sometimes involves tests to rule out other issues that could explain symptoms. Doctors may perform blood tests to check for evidence of celiac disease. A blood test also shows if a person has a low blood count, which indicates anemia. Anemia  is a condition caused by various problems that lead to insufficient amounts of healthy red blood cells. The body needs red blood cells to carry oxygen throughout the body. Anemia is linked to various gut disorders. Therefore, the presence of anemia indicates that irritable bowel syndrome may not be the cause of a person’s symptoms.

Doctors can also check for an infection by taking a stool culture. Stool cultures may reveal evidence of a malabsorption disorder as well.

A test called an erythrocyte sedimentation rate (ESR) is sometimes done to check for inflammation. This is a common blood test. A similar blood test that also checks for inflammation is called a C-reactive protein (CRP). Doctors use these tests because if inflammation is present then people are unlikely to have irritable bowel syndrome. Other gut disorders can lead to bowel inflammation, but irritable bowel syndrome does not.

In some cases, doctors may perform a procedure called a colonoscopy, which allows them to examine the colon for signs of gastrointestinal conditions and diseases, such as Crohn’s disease, ulcerative colitis or colon cancer. A colonoscopy involves a flexible tube equipped with a camera going into the anus and through the length of the colon.

A colonoscopy is typically used for patients who have bloody stools, unexplained weight loss, abnormal blood test results or who first presented with irritable bowel syndrome symptoms over the age of 50. These are some of the indicators that a more serious condition is behind a patient’s symptoms. Other indicators that prompt doctors to use additional tests include:

  • Abdominal pain that is not relieved by a bowel movement
  • Chronic diarrhea
  • Fever
  • Nausea
  • Rectal bleeding
  • Recurrent vomiting

Patients who do not have any of the above red flag indicators of more serious conditions may receive treatment for irritable bowel syndrome without further testing. However, if they do not respond to treatment doctors generally then perform tests to rule out other conditions.

Another test involving the colon that doctors may order when irritable bowel syndrome is suspected is called a flexible sigmoidoscopy. This test uses a flexible, lighted tube called a sigmoidoscope to view the sigmoid, which is the lower portion of the colon. Signs of malabsorption or abnormalities of the sigmoid show up during this exam.

Computerized tomography (CT) scans of the pelvis and abdomen are used to examine the internal organs to look for signs of disorders that cause symptoms similar to irritable bowel syndrome. CT scans make cross-sectional X-ray images that allow doctors to see a range of potential problems.

Treatments for Irritable Bowel Syndrome

Treatments for irritable bowel syndrome include medications for the condition and medications to manage the symptoms. Some people’s irritable bowel syndrome is not severe enough to require conventional treatment. As many as 70 percent of people who suffer from irritable bowel syndrome do not receive medical care for symptoms. They can tolerate their irritable bowel syndrome with diet and lifestyle modifications.

People whose irritable bowel syndrome is moderate to severe will require medication. The majority of conventional treatments for irritable bowel syndrome sufferers involves managing symptoms. Some medications are over-the-counter drugs while others are only obtainable with a prescription.

Medications for Irritable Bowel Syndrome Symptoms

Bowel spasms caused by irritable bowel syndrome can be exceptionally painful and medications may be needed to relieve these spasms. Anticholinergic medications affect the autonomic nervous system and can inhibit activities that cause bowel spasms. These medications can relieve diarrhea, but may make constipation worse.

Antispasmodic medicines may also help spasms in the muscles of the intestines and relieve the pain they cause. A doctor can prescribe one of several antispasmodics, such as mebeverine or hyoscine. The medications work differently so if a person does not respond to one type of antispasmodic medicines then a doctor may prescribe a different one. Furthermore, the affordable care act and the health care reform tax credit may alleviate some of the financial burden associated with such prescription medications. People take these medicines as needed when they experience pain. The medications can reduce pain but are unlikely to make it disappear completely. Taking these drugs for about a week at a time is normal. Antispasmodic medicines can prevent irritable bowel syndrome pain that occurs post-meals if taken before eating.

Antidiarrheal medications may relieve diarrhea related to irritable bowel syndrome. People can purchase antidiarrheal medications like loperamide (Imodium) over-the-counter.

Some people with irritable bowel syndrome suffer also from depression. Doctors may treat depression with antidepressant drugs, including selective serotonin reuptake inhibitors and tricyclic antidepressants. Selective serotonin reuptake inhibitors include well-known antidepressants, such as paroxetine (Paxil), fluoxetine (Prozac) and sertraline. These antidepressants may relieve pain and constipation as well.

Tricyclic antidepressants are also effective for reducing abdominal pain and diarrhea. Tricyclic antidepressants include imipramine, trimipramine(Surmontil), amitriptyline (Elavil) and desipramine (Norpramine). For people with those symptoms who are not depressed, lower dosages of tricyclic antidepressants may be prescribed.

Some antidepressants may cause side effects including, drowsiness, diarrhea and constipation.

Infections may cause irritable bowel syndrome, though this has not yet been established. Some doctors therefore believe that antibiotics may help people who have an overgrowth of bacteria in their intestines.

In addition to medications, doctors may recommend fiber supplements to relieve constipation associated with irritable bowel syndrome. Fiber from supplements helps to soften stools so they pass more easily through the intestines and out of the body. Fiber supplements include psyllium (Metamucil) or methylcellulose (Citrucel). The American Dietetic Association recommends 20 to 35 grams of fiber daily for adults, which can come from food or supplements.

Medications for Irritable Bowel Syndrome

Only two medications are known to effectively treat irritable bowel syndrome. These approved medications are only prescribed when other treatments have failed. The two medications include lubiprostone (Amitiza) and alosetron (Lotronex).

Lubiprostone is a chloride channel activator that is effective for increasing fluid secretion in the intestines, which assists in passing stools. The medication is approved only for women. It is generally given to women with severe constipation. It is not approved for use in children.

Lubiprostone causes side effects, including diarrhea, abdominal pain and nausea. More research is needed to fully determine if the medication is safe and effective.

Alosetron may help to relieve diarrhea associated with irritable bowel syndrome. It is also approved only for women. Alosetron works by promoting relaxation of the intestinal muscles. This slows the passage of stool through the lower bowel.

Alosetron had been approved for use but was then withdrawn from the market because of its side effects and suspected link to serious complications. The U.S. Food and Drug Administration approved alosetron for use again, but with restrictions. Only doctors who are gastroenterologists and enrolled a special program are allowed to prescribe alosetron now.

Men, children and teenagers should use other medications, diet changes, therapy or supplements instead of these irritable bowel syndrome medications. Prescribing either of these medications is rare even among adult female patients with irritable bowel syndrome.

Psychological Therapy

Psychological therapy may lessen symptoms of irritable bowel syndrome. Typically, people who have moderate-to-severe symptoms that have not responded to other treatments and symptoms that are suspected of being linked to psychological factors are candidates for psychological therapy. Yet there are different types of therapy. Some types of therapy may work better for certain individuals or for different symptoms.

People who are depressed or suffer from stress may find that counseling helps more than antidepressants. Combining the two may be the best way to treat irritable bowel syndrome in some individuals.

Talk therapy can be effective for treating people with irritable bowel syndrome and stress. Talk therapy may help individuals lower their stress levels. This type of treatment may be used in conjunction with other types of therapy, such as cognitive behavioral therapy or interpersonal therapy.

Cognitive behavioral therapy emphasizes observing and changing people’s thoughts and actions. Therapists show their patients how perceptions of their lives and even of themselves can be inaccurate. Through changing perceptions, cognitive behavioral therapy may relieve irritable bowel syndrome symptoms and improve quality of life.

Interpersonal therapy for irritable bowel syndrome treatment focuses on how people’s emotions affect their irritable bowel syndrome symptoms. Therapists teach their patients techniques for stress management and relaxation. Interpersonal therapy is also known as psychodynamic therapy.


Hypnotherapy is the use of hypnosis to put patients into an altered state of consciousness, or trance. Hypnotherapy is deeply relaxing. Studies show that gut-directed hypnotherapy, which focuses on relaxation of the intestines, can relieve irritable bowel syndrome symptoms by relaxing muscles in the bowels.

Patients experience not only relief from physical symptoms, but also improvement in emotional symptoms of irritable bowel syndrome. People with irritable bowel syndrome report improved emotional quality of life after receiving hypnotherapy sessions.

Dietary Modifications

Many people experience a reduction in irritable bowel syndrome symptoms through changing their diet and eating habits. A helpful tool for irritable bowel syndrome patients is a food journal. Patients record what they eat and when, plus if they experience any irritable bowel syndrome issues. The journal can identify harmful patterns or specific foods that cause symptom flareups.

Working with a registered dietician often results in improvements as well. A dietician may recommend  substituting certain foods for others and eliminating trigger foods. For example, a person who has a lactose intolerance and has symptom flareups after consuming dairy products may be able to tolerate yogurt containing live bacteria cultures. The bacteria in some yogurt can make digesting lactose easier. For people who need to eliminate dairy completely, a dietician helps to ensure patients still get adequate amounts of nutrients like calcium from the rest of their diet.

Some people may experience relief from eating smaller meals. Large amounts of foods may lead to diarrhea and abdominal cramps. The body digests smaller portions more easily than large meals. Consuming six small meals instead of a large breakfast, lunch and dinner helps some irritable bowel syndrome sufferers. Eating more slowly may help too as eating quickly can cause people to swallow air, which leads to abdominal gas. Chewing gum is another time people can swallow air.

Increasing fluid intake may improve irritable bowel syndrome. People with diarrhea can particularly benefit from drinking six to eight glasses of water daily, though this is a good rule of thumb for most people. Substituting regular water for carbonated water and other carbonated drinks can relieve abdominal gas and discomfort.

Adding more fiber foods to the diet may be effective for irritable bowel syndrome, especially for sufferers who have constipation. Increased fiber intake can also reduce diarrhea and pain. High-fiber diets can keep a colon mildly distended, which sometimes prevents colon spasms. Fiber helps retain water in the stool so that stools are soft and can pass easily through the colon. Whole grain products, such as cereals, pastas and breads, are high in fiber. Vegetables and fruits are also rich in fiber, though people with irritable bowel syndrome are sometimes advised to limit their fresh fruit intake to three portions a day.

However, not all fiber is the same. Some fiber is water soluble and other fiber is insoluble. Insoluble fiber helps with constipation because if adds bulk to stool, which lets stool pass more quickly. Whole grains, seeds, nuts, some fruits and vegetables contain insoluble fiber. Some irritable bowel syndrome sufferers may benefit more from adding soluble fiber to their diet. Soluble fiber slows digestion. Oats, dried beans, citrus fruits, potatoes and barley are good sources of soluble fiber.

Some people experience abdominal bloating and gas when first switching to a high-fiber diet, but these symptoms typically resolve themselves in a few weeks. Gradually increasing fiber by two to three grams daily decreases the risk of abdominal bloating and gas.

People with celiac disease should increase their fiber intake from fruits, vegetables and grains that do not contain gluten, such as buckwheat, rice and quinoa.

Irritable bowel syndrome sufferers who experience flatulence and abdominal gas may find relief from eliminating high-gas foods from their diet. Foods that may cause abdominal gas include:

  • Broccoli
  • Cabbage
  • Carbonated beverages
  • Cauliflower
  • Raw fruits

Other raw vegetables and dishes that contain mainly raw produce, like salads, can also lead to abdominal gas.

Increasing the amount of oats people eat can also reduce flatulence and abdominal gas. Oatmeal and porridge are two common dishes that are full of oats. Taking up to one tablespoon daily of linseed can also help.

People with irritable bowel syndrome and diarrhea may benefit from avoiding foods known to stimulate the intestines. Stimulatory foods linked to diarrhea include:

  • Alcohol
  • Caffeine
  • Dairy
  • Fatty foods
  • Sorbitol
  • Sugary foods
  • Xylitol

Sorbitol and xylitol are artifical sweeteners often used in sugar-free candy and chewing gum. They may also be used in diabetic foods and weight loss products.

Alternative Treatments

Alternative treatments bring relief to many people with irritable bowel syndrome. These treatments may not be the first choice on medical professionals, but are often recommended as complementary therapy to support regular irritable bowel syndrome treatment therapies.

Stress Reduction

Stress reduction is also a known factor in gut and bacterial health. When under chronic stress, the mechanisms that maintain harmony in the intestinal tract function less optimally and can break down altogether. What was previously described as the brain/gut axis postulates that there is a definite correlation between the psychological and mental state and digestive health. People who consistently maintain a high stress lifestyle, with the attendant hormones that it provokes are at risk for bacterial imbalances and IBS. Finding ways to minimize and deal more effectively with stress can greatly reduce symptoms. Such means can include, journaling, the Emotional Freedom Technique or Psychotherapy.


Acupuncture is popular with irritable bowel syndrome sufferers. Even though it is an alternative therapy and there is no conclusive evidence that acupuncture is effective for irritable bowel syndrome, acupuncture is proven to reduce chronic pain.

Studies show mixed results for use of acupuncture as an irritable bowel syndrome treatment, but some people do report feeling better after receiving acupuncture treatments. Acupuncture needles placed in specific areas of the body may stimulate electromagnetic signals that boost the body’s healing processes or cause pain-reducing chemicals to be released.

Acupuncture has been used for thousands of years as part of traditional Chinese medicine. However, even in China acupuncture is used along with other therapies.

Colonic Irrigation

Colonic Irrigation is also employed by holistic practitioners to help alleviate the symptoms of Irritable Bowel Syndrome, specifically constipation. By introducing a flow of water directly into the colon by way of the anus, old impacted fecal matter is broken down and swept away. Many individuals find that after 3-7 colonic sessions-in addition to diet changes- they no longer suffer from chronic constipation.


Various oils may help to calm the intestines and relief symptoms of irritable bowel syndrome. Oils come in capsule and liquid supplements.

Peppermint oil is a natural method to treat irritable bowel syndrome that studies show is more effective for symptom relief than a placebo. However, peppermint oil may not work for everyone and some people experience heartburn.

Evening primrose oil derived from the seed of a wildflower may also be beneficial for irritable bowel syndrome. Women whose irritable bowel syndrome symptoms become worse during their menstrual cycle are most likely to experience relief from evening primrose oil. The oil may cause side effects, including headache, upset stomach and rash.

Borage oil may be beneficial for some people as well. This oil comes from a common weed.

Castor oil can help as topical applications. Castor oil packs applied to the skin may reduce muscle cramps. Experts recommend covering packs with a cloth and then putting a heat source on top of the pack for 30 to 60 minutes.


Probiotics are beneficial bacteria. Eating probiotic foods or taking probiotic supplements can help restore an ideal balance of bacteria in the digestive tract. Some people have an overgrowth of harmful bacteria in their gut that may contribute to irritable bowel syndrome. Probiotics can inhibit bacteria overgrowth and thus improve irritable bowel syndrome.

Some studies show that people with irritable bowel syndrome who use probiotic treatment experience significant improvement in quality of life and fewer irritable bowel syndrome. Probiotics can reduce diarrhea. Specifically, the cultures Lactobacillus acidophilus and Bifidobacteria infantis may be the most beneficial for irritable bowel syndrome.

Yogurt is a well-known probiotic food, but other foods may contain probiotics too. Cheese, milk and frozen yogurts can also have probiotic bacteria. However, this is only true of products labeled “active cultures” or “containing live bacteria.” Products that do not contain live bacteria do not help the digestive system.


Herbal remedies are popular among irritable bowel syndrome sufferers. A registered herbalist may recommend different herbal remedies depending on the individual and what other treatments are being used. Herbalists may recommend herbal blends as well.

Sometimes, blends of 20 to 40 herbs in one supplement are used successfully as herbal remedies for irritable bowel syndrome. A mixture of herbs like ginger, wormwood, dan shen and bupleurum have been shown to decrease irritable bowel syndrome symptoms.

Peppermint is also a commonly used herb for irritable bowel syndrome due to its calming effect on the colon. A more relaxed colon is less likely to produce abdominal discomfort and diarrhea. Herbalists frequently recommend peppermint use along with other herbs, not on its own or for prolonged periods of time. Experts say that enteric-coated peppermint capsules are less likely to cause heartburn than other peppermint supplements.


Melatonin supplements may be beneficial for irritable bowel syndrome. Melatonin is a hormone that regulates the body’s circadian rhythms necessary for sleep. Melatonin also controls other hormones. It is secreted by the pineal gland in the brain, but not everyone’s brains produces enough of the hormone. Taking two to five milligrams of a melatonin supplement before bedtime can improve sleep and reduce irritable bowel syndrome symptoms.

Ground flaxseed supplements can reduce symptoms of irritable bowel syndrome too. Six to 24 grams daily can relieve constipation. Taking flaxseed may also decrease abdominal bloating and discomfort.

Homeopathic Medicine

Homeopathic medicine, also called homepathy, is an alternative medicine that may be helpful for some people with irritable bowel syndrome. Homeopaths may recommend natural remedies that come from plants or animals. Some of these treatments may be similar to herbal remedies or supplements prescribed by other alternative health practitioners, but homeopathic medicine operates on unique principles.

Homeopathic medicine follows two main principles to treat patients. The principle of similars suggests that conditions may be cured using a substance that causes similar symptoms to the condition. The principle of dilution states that lower doses of medications produce greater effects. Homeopaths may significantly dilute irritable bowel syndrome remedies to the point where the final solution may not even contain any of the healing substance. Homeopathic practitioners believe that diluted remedies still contain the essence of the cure. This stimulates the body to heal itself.

There have not been enough studies on homeopathic medicine for irritable bowel syndrome to decide conclusively whether it may help sufferers.

Chiropractic Treatments

Some irritable bowel syndrome sufferers find relief from chiropractic treatments. Chiropractors perform spinal manipulations that may help irritable bowel syndrome by providing a balancing effect on the nerves that send impulses from the brain to the intestines.


Exercise can be an effective means of regulating bowel function and minimizing some of the symptoms of Irritable Bowel Syndrome. Often, if a person is sedentary, their bowel function decreases, leading to constipation, trapped gas and pain. Exercise helps the body to move waste through the intestines and effectively expel toxins. If an individual is unable or unwilling to engage in strenuous exercise, even something such as a brisk walk after meals can be beneficial to colon health.

Massage, especially colon massage techniques can be a beneficial way to stimulate sluggish digestive system and move waste through the body. For the best results, your masseuse should be trained in this area, which is called Deep Abdominal or Colonic Massage. During the session, the practitioner will massage in a focused, deep and rhythmic manner and will concentrate on the abdominal cavity, lower and upper back and shoulder area. This therapy has been effective in reducing a wide range of symptoms, from Irritable Bowel Syndrome to menstrual problems. For obvious reasons, this should not be attempted during pregnancy.

Cranial-sacral and bio-feedback therapy

This has been shown to be effective in dealing with stored emotional issues or trauma that may unknowingly be stored in various parts of the body. A practitioner will work to identify blockages and help a person to confront and move through emotions that may be affecting their body’s ability to function. As stress and trauma cause changes in hormonal secretion and neurotransmitter function, as well as immune system effectiveness in the brain/gut axis, it is highly likely that stored negative emotions can cause IBS.

Additional Treatments

A few other alternative treatments may help make irritable bowel syndrome more tolerable. Heat reduces muscle spasms and abdominal cramps. A jacuzzi, hot bath, hot water bottle, sauna or heating pads are easy ways to apply heat to the abdomen.

Complications from Irritable Bowel Syndrom

If left untreated, some cases of Irritable Bowel Syndrome can cause additional problems. It is not uncommon for people with IBS to develop a secondary ailment, and often more than one. Some possible progressions of IBS and secondary conditions are:

Depression and anxiety are very common in individuals with IBS. An estimated three fourths of IBS sufferers experience a bout of anxiety at some point in their illness, with half developing long term General Anxiety Disorder. Antidepressants are the common treatment for this, but the physician needs to be sure that the medication will not cause the symptoms of IBS to worsen, which can often happen.

Diverticulosis is another possible condition that may develop in individuals with Irritable Bowel Syndrome. A recent study showed that 19% of women with IBS and 9% of men were diagnosed with this condition. In diverticulosis, small pouches develop inside of the large intestine. They form due to ongoing pressure in the intestines, where fecal matter presses against weak areas of the intestines. These areas can eventually become infected and inflamed, however, that only occurs in 20% of cases.

Acne can often materialize due to digestive issues. If food is not properly assimilated and waste products build up in the bowels and blood stream, are emitted that try to escape through the skin. When individuals successfully treat bowel and digestive irregularity, they often see a drastic improvement in their skin.

Miscarriage and eptopic pregnancy can result from long term Irritable Bowel Syndrome. A study showed that 6.6% of women with IBS experienced spontaneous miscarriage, with another .74 percent experiencing an eptopic pregnancy. Researchers are still unclear as to exactly why IBS affects pregnancy and additional research will need to be done.

Insomnia or restless sleeping patterns can also be present in those with Irritable Bowel Syndrome. Often, the symptoms of the disease cause one to be in constant pain or need to use the bathroom frequently due to diarrhea, etc. Because of this, consistent, restful sleep patterns may be elusive.

Social Anxiety may also present itself in those with IBS. Due to the nature of the illness, many sufferers are self conscious about what are often uncontrollable body spasms that result in bloating, flatulence and a need to frequently eliminate. Because of the sensitive nature of IBS, many sufferers are uncomfortable in social situations or in taking long trips without ready access to a bathroom. This may hinder their ability to socialize normally with family and friends, attend work functions and travel.

Recent research shows that women with irritable bowel syndrome are at a higher risk of miscarriages and ectopic pregnancies. Ectopic pregnancies are abnormal pregnancies that develop outside of the uterus. Women in general have 25 percent chance of suffering a miscarriage. Only one out of 100 women have an ectopic pregnancy. The statistical difference of miscarriage and ectopic pregnancies between women with and without irritable bowel syndrome is small but measurable.

Prevention of Irritable Bowel Syndrom

The symptoms of Irritable bowel syndrome can be reduced or prevented by incorporating diet and lifestyle changes such as the following:

  • Greatly increase your water intake
  • Eliminate irritating foods such as refined sugar, gluten, coffee and alcohol, and milk can help to prevent symptoms.
  • Carefully monitor the body after taking antibiotics and supplement with probiotics to repopulate the colon with health bacteria.
  • Maintain a moderate exercise regimen, which will help to expel waste naturally and prevent constipation.
  • Add plenty of fiber to the diet in the form of dark leafy greens, psyllium husks, flax seed and other healthy sources of roughage.
  • Eat smaller, more easily digestible portions.
  • Try to reduce sources of stress and seek treatment for uncontrolled anxiety, as these are contributors to IBS.
  • Practicing Meditation or other mind/body technique to calm the nervous system.


Medically trained in the UK. Writes on the subjects of injuries, healthcare and medicine. Contact me

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