Management Guidelines for Irritable Bowel Syndrome

Management Guidelines for Irritable Bowel Syndrome


We know by now that we need to eat the right foods, need to work out, and do stuff that is healthy for us. Because maintaining good health does not happen by accident, it requires work and smart lifestyle choices. But sometimes when we wake up at 6 am to hit the gym before work or shunning the donuts in breakfast, it’s easy to lose sight of for what are we doing all these. So here are some top articles choices that can keep you motivated to lead a healthy lifestyle and keep diseases at bay.

Management Guidelines for Irritable Bowel Syndrome

IBS (Irritable Bowel Syndrome) is very common gastrointestinal problem and affect huge number of people, affecting 7% to 10% people. American College of Gastroenterology, issued a management guideline for IBS, which replace the guideline issue in the year 2002. As, IBS is a real disease and real medical problem with disturbing symptoms, it is important to know latest treatment/management guidelines, which include use of new therapies (such as use of probiotics) as well as use of alternative medicine (such as acupuncture) to counter the nuisance. Most management guidelines focus on relieving symptoms, rather than going into the disease itself, and new guideline also essentially does same, as there is not much change from the practitioner’s point of view, although the latest guideline for management of IBS is thorough.

  • Data on use of probiotics, is not sufficient and more studies and data are required to come to clear conclusion. Nonetheless, many people claim to benefit symptomatically of using probiotics. The dosage (number of live bacteria used), the number of different bacteria species used need to be well thought before using probiotics for IBS, taking into consideration, local prevalence of gut bacteria.
  • Fiber medications/products, such as psyllium, anti-spasmodic medications and peppermint oil may be effective in at least some patients. There is no strong evidence, but many patients say there is symptomatic improvement. However, fiber needs to be used cautiously in patients with narrow colon.
  • In patients with “diarrhea predominant IBS”, antibiotics for GIT, which are not absorbed, such as rifaximin seem to be helpful among some patients.
  • Selective C-2 chloride channel activators, such as lubiprostone (Amitiza), can be effective for “constipation-predominant IBS.”
  • 5HT 3 antagonists such as alosetron (Lotronex) relieve symptoms of diarrhea but can cause constipation and colon ischemia, a restriction of blood flow
  • SSRIs (selective serotonin reuptake inhibitors) and tricyclic antidepressants are also commonly used for IBS management. SSRIs (selective serotonin reuptake inhibitors) and tricyclic antidepressants are quite effective in many patients and many studies are there to support this, although these studies were conducted on small number of patients, but well documented and scientific. Larger studies may change the outcome, to some extent, though.
  • 5HT 4 agonists, (which are effective against constipation), are also used by many practitioners in many countries, but not available in North America because of a heightened risk of cardiovascular problem.
  • Currently there is no supportive evidence that, food allergies can aggravate or certain diet can help in IBS.
  • Complementary and alternative medicines are being tried with inconsistent results. Effectiveness of acupuncture is uncertain. Some Chinese herbal mixtures are also tried for IBS management. The result is uncertain and there is risk of liver damage. Hence, should not be used.
  • Diagnosis of IBS is still based on clinical examination and history and routine diagnostic testing for IBS should not be done, although some patients may need certain tests done.

All patients undergoing for IBS as well as physicians treating/managing IBS patients, should know about the guidelines for management of IBS (Irritable Bowel Syndrome) by American College of Gastroenterology, which will be beneficial for them.

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