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The treatment of the irritable bowel syndrome (IBS) is based on relieving symptoms.
Mild symptoms are generally managed by bringing about changes in the lifestyle and diet and by managing stress.
Moderate to severe cases of IBS generally needs medicines and mental health therapies.
There are multiple treatment options available for IBS,where few options works better than others in some people. Collective effort of the doctor, patient and dietician can help to make a right treatment plan.
• Increasing physical activity or exercising regularly
• Avoiding stress and trying out relaxation techniques like yoga, massages etc.
• Getting enough sleep
Following changes may be recommended by the doctor or the dietician:
• Eating more fiber: may relieve constipation in patients of IBS. It is recommended to take 22-34 grams of fibers per day. Fibers should be gradually added to the diet, about 2 to 3 grams per day, to avoid bloating and gas. There are two types of fibers, soluble and insoluble. Amongst these soluble fibers present in fruits, beans and oats are found to be more helpful in IBS.
• Avoiding food that triggers the symptoms: in some people it may be caused by gluten, a protein found in wheat, barley and rye. These people develop symptoms of IBS even in absence of celiac disease. While in some, it may be caused by certain carbohydrates present in food like fructose, lactose and others called as FODMAPs. Following a low FODMAP diet may help to reduce symptoms in these people.
• Drinking plenty of fluids
Generally given in moderate or severe symptoms or when lifestyle or diet changes are nit helpful. There are different medicines available for different symptoms:
• Fiber supplements: Taking a fiber supplement with fluid may help relive constipation.
• Laxatives: If fiber doesn’t work the doctor may give magnesium hydroxide oral or polyethylene glycol.
• Anti-diarrheal medications: loperamide, may control diarrhea.
• Anticholinergic medications: these medicines are sometimes given to people with diarrhea, eg: dicyclomine.
• Selective serotonin reuptake inhibitor(SSRI) antidepressants: These medicines may be given to people having IBS with constipation and depression, eg: fluoxetine or paroxetine.
• Tricyclic antidepressants: These medicines can help relieve depression as well as reduce hyperactivity of gut neurons to help reduce pain. In absence of depression, a lower dose is given. Eg: imipramine, desipramine, Norpramine etc.
• Pain medications: medicines like pregabalin or gabapentin might be given in severe pain or bloating.
• Probiotics: some doctors might give probiotics to correct the alteration in the normal gut bacteria.
In some patients the doctor may advise mental health therapies and counseling to help provide relief IBS. These can be:
• Cognitive behavioral therapy: helps in changing thoughts and behavior pattern to manage IBS symptoms.
• Gut-directed hypnotherapy: where a therapist uses a hypnosis to help improve symptoms.
• Relaxation techniques: may help to reduce stress or tension.
Finding ways to deal with stress may help prevent or ease symptoms of IBS. Consider trying:
• Counseling. A counselor can help you learn to modify or change your responses to stress. Studies have shown that psychotherapy can provide significant and long-lasting reduction of symptoms.
• Biofeedback. Electrical sensors help you receive information (feedback) on your body’s functions. The feedback helps you focus on making subtle changes, such as relaxing certain muscles, to ease symptoms.
• Progressive relaxation exercises. These exercises help you relax muscles in your body, one by one. Start by tightening the muscles in your feet, then concentrate on slowly letting all of the tension go. Next, tighten and relax your calves. Continue until the muscles in your body, including those in your eyes and scalp, are relaxed.
• Mindfulness training. This stress-reduction technique helps you focus on being in the moment and letting go of worries and distractions.
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