How Your Doctor Should Treat IBS

The American College of Gastroenterology has just updated its recommendations for the management of irritable bowel syndrome, or IBS. They’ve posted their report in the American Journal of Gastroenterology; here are some of the salient features: 

• Most patients can be diagnosed with IBS without extensive testing, as long as they don’t have any ‘alarm’ features – bleeding, weight loss, or colon cancer in the family.
•  IBS patients with diarrhea should have a blood test to exclude celiac disease
•  Antidepressants can be very helpful for many patients; they should be taken before going to bed, in low doses.
•  Lubiprostone (Amitiza®) is useful for IBS with constipation in women.
•  Probiotics containing Bifidobacter infantis are beneficial in some patients.
•  Rifaximin (Xifaxan®), a non-absorbable antibiotic, may help with bloating and diarrhea.
•  As stress can play a prominent role, cognitive behavioral therapy, and possibly hypnotherapy, may be helpful in some patients.
•  Dietary changes:
  • Avoid gas-producing foods (beans, onions, broccoli).
  • Eat slowly, and lesser amounts.
  • Avoid fizzy drinks
  • Watch out for food types (e.g. dairy, sugars, lactose) that may make things worse.
  • Add soluble fiber (psyllium, as in Metamucil®) if constipated.

 All in all, there are many ways that people with IBS can be helped; finding an understanding, experienced, and patient physician is probably the best place to start.