Treatment for IBS

Irritable bowel syndrome (IBS), or functional colopathy, is an often painful disorder affecting the digestive system that is aggravated by stress. From a low FODMAP diet to probiotics and hypnotherapy, Guillaume Gourcerol, a gastroenterologist and hepatologist at Rouen university hospital center (CHU Rouen) in France, takes us through some of the latest and most effective approaches to treatment.

Is there a typical patient profile for people with irritable bowel syndrome (IBS)?

There is no typical profile. However, patients are 80% female and present anxious, sometimes obsessive temperaments. Half have experienced a highly stressful situation or event. There are sometimes associated illnesses, such as functional dyspepsia, fibromyalgia, painful bladder syndrome, migraines, sleep disturbances, etc.

What currently available drugs are effective in treating IBS?

Antispasmodic medication, used as a long-term treatment or during flare-ups, can bring relief. In the event of small intestine bacterial overgrowth, antibiotics may be recommended.

What tests can be used to diagnose IBS?

No medical tests or procedures can diagnose the condition. It doesn’t show up on an endoscopy (looking inside the body with a camera). However, patients can take tests for intolerance to lactose or fructose.

What dietary strategy can IBS sufferers adopt?

A low FODMAP diet excluding a family of poorly digested sugars (pears, apples, plums, wheat, barley, rye, legumes, artichoke, chicory, Jerusalem artichoke, Brussels sprouts), is currently one of the only dietary strategies that has been scientifically proven to improve IBS symptoms as well as quality of life for patients. It is, however, very difficult to follow long term, as FODMAPs are everywhere in foodstuffs. I recommend patients see a nutritionist or a dietician on a regular basis.

Can a gluten-free diet improve IBS?

Cutting out gluten is of no interest. Patients risk developing deficiencies or even eating disorders. In fact, when you follow a low FODMAP diet, you also remove gluten.

How is research and development advancing on new probiotics for the treatment of IBS?

Among the many strains tested in serious randomized studies, VSL3 — sold in certain countries under the name Alflorex — is a treatment that works. Bifidobacterium infantis 35624 and Lactobacillus plantarum 299v are among the most effective.

What kind of complementary therapy could be envisaged?

Hypnotherapy works very well for patients and this treatment can suffice in certain cases. A good relationship should be established with the practitioner who will teach the patient to self-hypnosis techniques.

Guillaume Gourcerol, a gastroenterologist and hepatologist at Rouen university hospital center (CHU Rouen) in France, will present these latest findings at the Entretiens de Bichat medical conference, held October 5-7 at the French capital’s Palais des Congrès de Paris.

Extract from Yahoo


Relaxation intervention improves symptoms, may help treat IBS, IBD

Participation in a relaxation response based mind-body group intervention was associated with improvements in disease-specific measures, trait anxiety and pain catastrophizing in patients with irritable bowel syndrome and inflammatory bowel disease, according to study findings.The quality of life in patients with IBS and IBD is often significantly affected and influenced by stress and resiliency

Source: Relaxation intervention improves symptoms, may help treat IBS, IBD

Treament of IBS should focus on head as well as gut 

Source: Treament of IBS should focus on head as well as gut : Family Practice News

The pathophysiology of irritable bowel syndrome (IBS) was the focus of a presentation given by Dr. Anthony J. Lembo at the 2nd annual Digestive Diseases meeting in Philadelphia.
Specifically, Dr. Lembo discussed the debate about whether diagnosing the condition should focus on a patient’s gut or head; that is, if enhanced perception of a bowel disorder can lead to visceral hypersensitivity and altered motility, which results in a diagnosis of IBS when, in fact, the issue is psychosomatic. Dr. Lembo, a professor at Harvard Medical School and Beth Israel Deaconess Medical Center, explained that there is a growing shift toward diagnosing IBS as a brain-to-gut interaction rather than as something based purely on limited motility. Patients presenting with comorbid conditions such as depression, migraine, anxiety, neuralgia, chronic fatigue or pain, or fibromytosis are all more likely to not only have IBS, but to have more severe symptoms and lower quality of life.

Dr. Anthony J. Lembo
“When I see a patient who has a lot of these symptoms together, I realize that I need to be very aggressive and use a multimodal approach,” said Dr. Lembo. “I talk to their other physicians, and do more of the brain treatment, psychological treatment, CNS drugs, as well as some peripheral ones.”
For these reasons, Dr. Lembo said that the current Rome III criteria for treatment of IBS are not sufficient to be used on their own in diagnosing and treating IBS, saying “IBS is a heterogeneous disorder with both peripheral and central mechanisms” that must be treated as such. In treating the central nervous system, Dr. Lembo discussed 5-HT3 antagonists, serotonin modulators, antidepressants, and placebos. Peripheral treatments can come in the form of either diets, fiber regimens, antibiotics, GC-C agonists*, 5-HT3 antagonists, and probiotics/prebiotics, although efficacies and approvals vary.”

Bunny Besley adds comment:

Treatment involving both medication and psychologial intervention gives a more holistic approach and hypnosis is indicated as having successful outcomes to reduction of symptoms caused by the stress reaction in the gut.

IBS Treatment

IBS Treatment.

For many people this painful and often embarrassing condition can have a very negative impact on the quality of life and enjoyment of social interaction. In worst case scenarios the sufferer can become housebound and unable to face the prospect of being in a place where they cant guarantee being close to the toilet.

Diagnosis is often reached after extensive tests have shown no other specific cause and the best treatments that can be offered are antispasmodics and fibre boosting tablets. It is unclear what causes IBS in the first place but research has shown links to illness and stress. What ever the cause is, it is becoming evident that people with IBS have an imbalance of gut bacteria and that treatment with traditionally fermented foods and probiotics may be the best way forward. Research has also studied feeding people with this imbalance tablets containing the faeces of people with a healthy bacterial balance with very promising results.

The good news is that progress is being made into understanding more about this ever increasing health issue and that soon we will have much better options available.

The stress link is apparent and often treating this area can reduce symptoms and the worry associated with the issue. When you are stressed the bowel does not function as efficiently as it does in rest, since the body believes that stressful conditions mean you are in imminent danger of attack and it focuses its energy in being ready to flee or fight. It is possible prolonged periods in this state may be the cause of the bacterial imbalance in the first place and once this occurs the symptoms increase.

A treatment plan that covers all areas of IBS should be the most effective and a course of therapy coupled with dietary changes and increases in healthy bacteria through naturally fermented foods, such as sauerkraut, yogurts containing L.acidophilus or quality health supplements that contain L.acidophilus is to be recommended.