Thursday, May 7, 2009

IBS Resources

Mirrored from Aurametrix

IBS is a disorder of heterogeneous pathophysiology for which there are no good diagnostic tests nor effective treatments (online study on unmet needs conducted by IFFGD and UNC). Existing tests are performed to exclude diseases such as IBD, colorectal cancer, diseases associated with malabsorption, systemic hormonal disturbances, and enteric infections.
Routine serologic screening for celiac sprue in patients with IBS-D or IBS-M may be useful.
Lactose intolerance can cause IBS-D, intolerances to other food groups such as

Percentage of population with IBS reported in ...Image via Wikipedia

fructose could be also implicated. Problems with serotonin signaling, or the transmission of messages between the nerves, can lead to IBS-C

The guidelines, issued by the American College of Gastroenterology were published in the January2009 issue of The American Journal of Gastroenterology.

Most IBS treatments relieve symptoms rather than resolve the condition itself.

The new guidelines encompass existing evidence on conventional treatments for IBS as well as new therapies (probiotics, for example) and alternative therapies (acupuncture and more).

Fiber products -- including psyllium, anti-spasmodic medications and peppermint oil -- may be effective in some people. "The evidence is poor, but some patients say they feel better,"

More data is needed on probiotics, live microorganisms (usually bacteria) similar to the "good" organisms found normally in the gut. The dichotomous data suggest that all probiotic
therapies have a trend for being efficacious in IBS, whereas the
continuous data indicate that Lactobacilli have no impact on
symptoms; probiotic combinations improve symptoms; and
there is a trend for Bi fidobacteria to improve IBS symptoms.Researchers and practitioners still need to figure out the species of bacteria used, how many species, and dosages.

Non-absorbable antibiotics -- those targeted to the gut only, such as rifaximin (Xifaxan) -- also seem to help some people, especially those who have "diarrhea-predominant IBS."

Selective C-2 chloride channel activators, notably lubiprostone (Amitiza), are 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.
5HT 4 agonists, though effective against constipation, are not available in North America because of a heightened risk of cardiovascular problems.

There is yet to be conclusive evidence on Chinese herbal mixtures, and the mixtures run the risk of causing liver failure and other problems. Differences in the content of compounds and the purity of ingredients complicate evaluation of benefits.

Similarly, the evidence on acupuncture remains inconclusive.

There is no evidence at this point that testing for food allergies or following diets that exclude certain foods alleviates IBS symptoms.

Routine diagnostic testing for IBS is not recommended, although some testing should be performed in certain subgroups of patients.

More about IBS at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases site.

To ease IBS with diarrhea, avoid fried foods, too much fiber, especially insoluble such as apple skins, chocolate, alcohol, caffeine, carbonated drinks, the artificial sweetener sorbitol (found in sugarless gum and mints), and fructose (the simple sugar found in honey and many fruits). These can worsen diarrhea symptoms. Drink six to eight glasses of plain water a day - not with meals, but an hour before or an hour after meals. Avoid drinking hot teas.

To ease IBS with constipation, drink water and exclude beverages as suggested above. Eat small frequent meals and be careful with fiber. Soluble is better at reducing severety of symptoms, as was shown in this 2005-2007 clinical trial, but all types of fiber could potentially worsen the syndrome. You may also want to exclude broccoli and other dark green vegetables from your diet. Keep an IBS symptom journal, it would help you and your doctor to find what foods and situations trigger your IBS symptoms.

Not Censored IBS Diet Links:

More Links:

International Foundation for Functional Gastrointestinal Disorders (IFFGD) sites:
Chronic Constipation
Acid Reflux Disease (GERD)
Motility Disorders
Irritable Bowel Syndrome (IBS)
Incontinence or Urgency
Digestive Disorders in Kids
and Teens
Digestive Health Research
Participate in IBS survey

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