Irritable Bowel Syndrome (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Irritable bowel syndrome (IBS) facts
- What is irritable bowel syndrome (IBS)?
- What causes irritable bowel syndrome (IBS)?
- What are symptoms of irritable bowel syndrome (IBS)?
- What are the complications of irritable bowel syndrome (IBS)?
- How is irritable bowel syndrome (IBS) diagnosed?
- How is irritable bowel syndrome (IBS) treated?
- Constipation medications
- Diarrhea medications
- Abdominal pain medications
- Psychotropic drugs
- Psychological treatments
- IBS Diet
- Is there a relationship between IBS and small intestinal bacterial overgrowth?
- What is a reasonable approach to irritable bowel syndrome (IBS)?
- What is in the future for irritable bowel syndrome (IBS)?
- Find a local Gastroenterologist in your town
Psychological treatments include cognitive-behavioral therapy, hypnosis, psychodynamic or interpersonal psychotherapy, and relaxation/stress management. These treatments have been used in patients with IBS who are psychologically distressed to the point that their quality of life is impaired. A few studies have shown that psychological treatments can reduce anxiety and other psychological symptoms in addition to reducing IBS symptoms, particularly pain and diarrhea.
It is unclear if diet has much effect on the symptoms of IBS. Nevertheless, patients often associate their symptoms with specific foods (such as salads, fats, etc.). Although specific foods might worsen IBS, it is clear that they are not the cause of IBS. The common placebo response in IBS also may explain the improvement of symptoms with the elimination of specific foods in some people.
Dietary fiber often is recommended for patients with IBS. Fiber probably is of benefit in IBS patients with constipation, but it does not reduce abdominal pain. Lactose (milk sugar) intolerance often is blamed for diarrhea-predominant IBS, but it does not cause IBS. Because they both are common conditions, lactose intolerance and IBS may coexist. In this situation, restricting lactose will improve, but not eliminate the symptoms. Lactose intolerance is easily diagnosed by testing the effect of lactose (hydrogen breath testing) or trying a strict lactose elimination diet. Intolerance to sugars other than lactose, specifically, fructose, sucrose, and sorbitol, may cause symptoms that are similar to IBS or make IBS worse. It is unlikely, however, that these sugars cause IBS.
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