Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) Treatment in Iran

Nearly all people with IBS can get help, but no single treatment works for everyone. You and your doctor will need to work together to find the right treatment plan to manage your symptoms.

Many things can trigger IBS symptoms, including certain foods, medicines, the presence of gas or stool, and emotional stress. You’ll need to learn what your triggers are. You may need to make some lifestyle changes and take medication.

 Mild signs and symptoms can often be controlled by managing stress and by making changes in your diet and lifestyle. Try to:

• Avoid foods that trigger your symptoms
• Eat high-fiber foods
• Drink plenty of fluids
• Exercise regularly
• Get enough sleep

Your doctor might suggest that you eliminate from your diet:

• High-gas foods.If you experience bloating or gas, you might avoid items such as carbonated and alcoholic beverages, caffeine, raw fruit, and certain vegetables, such as cabbage, broccoli and cauliflower.
• Research shows that some people with IBS report improvement in diarrhea symptoms if they stop eating gluten (wheat, barley and rye) even if they don't have celiac disease.
• Some people are sensitive to certain carbohydrates such as fructose, fructans, lactose and others, known as FODMAPs — fermentable oligo-, di-, and monosaccharides and polyols. FODMAPs are found in certain grains, vegetables, fruits and dairy products. Your IBS symptoms might ease if you follow a strict low-FODMAP diet and then reintroduce foods one at a time.

A dietitian can help you with these diet changes.

If your problems are moderate or severe, your doctor might suggest counseling — especially if you have depression or if stress tends to worsen your symptoms.

In addition, based on your symptoms your doctor might suggest medications such as:

• Fiber supplements.Taking a supplement such as psyllium (Metamucil) with fluids may help control constipation.
• If fiber doesn't help symptoms, your doctor may prescribe magnesium hydroxide oral (Phillips' Milk of Magnesia) or polyethylene glycol (Miralax).
• Anti-diarrheal medications.Over-the-counter medications, such as loperamide (Imodium), can help control diarrhea. Your doctor might also prescribe a bile acid binder, such as cholestyramine (Prevalite), colestipol (Colestid) or colesevelam (Welchol). Bile acid binders can cause bloating.
• Anticholinergic medications.Medications such as dicyclomine (Bentyl) can help relieve painful bowel spasms. They are sometimes prescribed for people who have bouts of diarrhea. These medications are generally safe but can cause constipation, dry mouth and blurred vision.
• Tricyclic antidepressants.This type of medication can help relieve depression as well as inhibit the activity of neurons that control the intestines to help reduce pain. If you have diarrhea and abdominal pain without depression, your doctor may suggest a lower than normal dose of imipramine (Tofranil), desipramine (Norpramine) or nortriptyline (Pamelor). Side effects — which might be reduced if you take the medication at bedtime — can include drowsiness, blurred vision, dizziness and dry mouth.
• SSRI antidepressants.Selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (Prozac, Sarafem) or paroxetine (Paxil), may help if you're depressed and have pain and constipation.
• Pain medications.Pregabalin (Lyrica) or gabapentin (Neurontin) might ease severe pain or bloating.

Can IBS be cured permanently?

IBS symptoms can come and go, but it's a condition you'll have for the rest of your life. There is no cure for it, but you can use a few different strategies to manage how you feel. National Institute of Diabetes and Digestive and Kidney Diseases: “Lactose Intolerance,” “Irritable Bowel Syndrome.”