What Else Should I Ask My Healthcare Provider
If you have IBS symptoms, ask your provider:
- Could another condition be causing my symptoms?
- What medications can help?
- What foods should I avoid?
- What other lifestyle changes should I make?
- Can a dietitian help me?
- Should I see a gastroenterologist?
- When will I start to feel better?
- Am I at risk for other health conditions?
A note from Cleveland Clinic
Living with irritable bowel syndrome, or IBS, can be challenging. IBS symptoms, such as stomach pain, diarrhea, gas and bloating, often interfere with your life. But IBS is manageable. Though there is no cure, you can control and improve symptoms through diet and lifestyle changes. If you have stomach symptoms that arent going away, talk to your healthcare provider. Together, you can find an IBS treatment plan that works for you.
Last reviewed by a Cleveland Clinic medical professional on 09/24/2020.
References
What Causes An Ibs Flare
It’s unclear what causes episodes of IBS symptoms, but several studies have shown the following factors may play a part in IBS flare-ups:
- Eating âtriggerâ foods: High FODMAPs foods may cause IBS symptoms.
- Stress: both short and long-term stress, for example from situations at work or in life in general, can increase gut problems.
- Gastrointestinal infection: Especially in severe cases, gut infections have been shown to trigger IBS symptoms.
- Psychological condition: anxiety, depression and post-traumatic stress disorder can all bring on an IBS flare-up.
How Long Does An Ibs Flare
IBS flare up duration is different for everyone. Most people’s IBS symptoms will flare-up for 2-4 days, after which your symptoms may lower in severity or disappear completely. Many people experience IBS in waves, in which symptoms may come and go over several days or weeks.IBS attacks can be managed to reduce symptoms or shorten duration using several management techniques .
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Be Cautious With Laxatives
Your over-the-counter choices can improve your IBS symptoms or make them worse, depending on how you use them. The Mayo Clinic recommends using caution if you use OTC antidiarrheal medicines, such as Kaopectate or Imodium, or laxatives, such as polyethylene glycol or milk of magnesia. Some medicines need to be taken 20 to 30 minutes before you eat to help prevent symptoms. Follow the directions on the package to avoid problems.
It goes without saying that certain foods can make gastrointestinal pain worse. Be on the lookout for which foods exacerbate your symptoms, and be sure to avoid them. Some common problem foods and drinks include:
Who Can And Cannot Take Loperamide
You can buy loperamide from pharmacies and supermarkets or you can get it on prescription.
Loperamide is available to buy without a prescription for:
- anyone aged 12 and older with short-term diarrhoea
- an adult with IBS diarrhoea, but only if a doctor has diagnosed IBS. If you are not sure whether you have IBS, talk to your doctor
It’s available on prescription only for:
- children again 11 years and younger
- young people aged 12 to 17 years with IBS or long-lasting diarrhoea
- adults with long-lasting diarrhoea
- tablets and capsules that contain 2mg of loperamide
- liquid that contains 1mg of loperamide in a 5ml spoonful
The recommended dose depends on the type of diarrhoea you have and your age.
Adults , with short-term diarrhoea or IBS
The usual starting dose is:
- capsules or tablets: take 2 capsules or tablets, taken immediately. Then take 1 capsule or tablet after each runny poo.
- liquid: four 5ml spoonfuls, taken immediately. Then take 2 spoonfuls after each runny poo.
Stop taking loperamide as soon as your symptoms settle down.
The recommended maximum dose in 24 hours is:
- 6 capsules or tablets, if you buy loperamide from a shop
- 8 capsules or tablets, or 16 spoonfuls of liquid , if you have a prescription or buy loperamide from a pharmacy
Do not take loperamide for more than 48 hours without talking to a doctor.
Adults with long-lasting or recurring diarrhoea
Your doctor will adjust your dose according to your symptoms and how well loperamide is working, up to a maximum of:
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Mindfulness For Stress Relief
Reducing stress with breathing exercises and mindfulness may also help calm down the gut nerves that are misfiring. The ACGs guidelines recommend various mindfulness techniques that have the potential to improve IBS symptoms. A study published in September 2020 in the journal Neurogastroenterology and Motility found that after an eight-week mindfulness-based stress reduction practice, more than 70 percent of the participants in the study reported improved IBS symptoms. The reduction in severity also continued for three months after the eight weeks of the study.
I recommend 5-5-5 to my patients, Powell says. That is, smell the roses by inhaling through your nose for a count of five. Hold that breath for five counts, then exhale through your mouth for a count of five or longer, as if you are blowing out candles on your birthday cake. This breathing technique is very calming to the autonomic nervous system, which can help with IBS, she adds. Best of all, its portable. You can do it anywhere, such as when youre waiting in your car at a stoplight.
I Learned To Tune Into My Body
One thing I am thankful to my IBS for is that its pushed me to really connect with my own body. When you have a rather needy condition like this one, you quickly become aware of what foods react badly, how you feel in certain situations, and how stress can take over rapidly.
Keeping a food diary can be very helpful for developing this connection with your body , and it really can give you insights into what causes flare-ups of your symptoms. Make note of everything youve consumed in one 24-hour period and how you feel, symptom-wise, after each meal and then at the end of the day. After a week or so, youll soon begin to see patterns that might help eliminate your triggers.
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How Does Ibs Affect My Body
In people with IBS, the colon muscle tends to contract more than in people without the condition. These contractions cause cramps and pain. People with IBS also tend to have a lower pain tolerance. Research has also suggested that people with IBS may have excess bacteria in the GI tract, contributing to symptoms.
Irritable Bowel Syndrome: What Helps And What Doesnt
There are a lot of treatments for the relief of irritable bowel syndrome but there’s a lack of good-quality research on them. Because it’s not clear what causes IBS, it’s difficult to find suitable treatments. But research has suggested that at least some medications and treatments may help.
The main symptoms of irritable bowel syndrome are abdominal pain, constipation and diarrhea. Most people only have mild symptoms that they can cope with fairly well without having treatment. Over time they learn to understand their body’s signals. But some people have more severe symptoms that greatly affect their everyday lives, so they look for a treatment to reduce the symptoms.
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Cautions With Other Medicines
Some medicines and Buscopan can affect each other and increase the chances of you having side effects.
Do not take Buscopan at the same time as some motion sickness medicines, such as domperidone and metoclopramide.
This is because they can cancel each other out and stop each other from working. Metoclopramide and domperidone increase the movement of the gut, whereas Buscopan reduces it.
Some medicines increase the risk of side effects if you take them at the same time as Buscopan, including:
- quinidine or disopyramide
- some inhaled asthma medicines, including salbutamol, ipratropium and tiotropium
Do not take Buscopan together with other irritable bowel syndrome remedies, as they work in the same way. You’re unlikely to get extra relief for your symptoms, and it may cause more side effects. Take only one IBS remedy, unless your doctor tells you to take more than one.
Common Medical Treatments For Ibs
Since the exact cause of IBS is not known, the goal of treatment is to reduce symptoms. If diet and lifestyle changes donât improve your symptoms, your healthcare provider may recommend IBS medications. Some common medications include:
- IBS medications: Some medications can help with IBS by either slowing the movement of material through the bowel to reduce diarrhea or by increasing fluid production in the small intestine to reduce constipation. Alosetron or Lubiprostone are two common IBS medications.
- Antispasmodics: These are designed to relax the smooth muscles of the colon to ease cramping and spasms. Two such medications are hyoscine and dicyclomine . They may cause side effects that include dry mouth, palpitations, and difficulty urinating.
- Antidiarrheals: These medications can be useful in treating severe diarrhea. But they should be taken with cautionâ antidiarrheals may have side effects such as nausea and vomiting and should be taken under close supervision. Loperamide is an example of an Antidiarrheal medication.
- Antidepressant medications: Certain antidepressants can help relieve diarrhea and constipation and may treat pain in IBS. They are often prescribed in lower doses for IBS than for depression. Antidepressants for IBS should be taken under supervision as side effects can include insomnia, nausea, and weight gain or loss. Some tricyclic antidepressants used for IBS include imipramine and selective serotonin reuptake inhibitors such as citalopram .
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Treat Your Symptoms With Appropriate Supplements Or Medication
The most popular herbal supplement that also has scientific backing, is called Iberogast .
It contains a mixture of herbs that can assist abdominal pain, flatulence and altered bowel habits.
There may also be some over the counter medication that can help IBS symptoms.
It is best to discuss your needs with a pharmacist.
Summary: There are a number of strategies that could be used to calm an IBS flare up. Symptoms will also pass with time.
Managing Irritable Bowel Syndrome
Most adults experience occasional constipation, diarrhea, bloating, gas, urgent bowel movements and cramping abdominal pain. However, for some people, these symptoms are a more regular occurrence affecting their quality of life and daily routine. Unfortunately, many of these individuals have what is known as irritable bowel syndrome yet dont know it because theyve never received an evaluation or diagnosis.
Often, people feel embarrassed discussing the symptoms of IBS with their medical provider. While as many as one in five American adults have signs and symptoms of IBS, fewer than one in five who has these symptoms seeks medical help. For most people, IBS is a chronic condition, which can fluctuate from producing mild to severe symptoms and sometimes symptoms disappear completely.
Impact and triggers
The impact of IBS and the way it manifests varies from person to person. Oftentimes, stimuli that fail to bother certain people may in turn trigger symptoms in others with IBS. For example, certain foods, emotional stress, hormones and other illnesses can all incite the symptoms of IBS.
Risk and susceptibility
While IBS can affect almost anyone, certain risk factors do exist, including people who are:
- Have a family history of IBS
- Have a history of anxiety or depression
Causes
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Which Medications Can Help Me Feel Better
You and your doctor can choose the right ones based on your symptoms and how bad they make you feel.
Anti-diarrhea medicines. Loperamide helps control your frequent loose stools. You can get them at the grocery or drug store.
Another medicine, diphenoxylate with atropine , is available with a prescription.
Meds to help cramping. You might hear your doctor call these “anticholinergic and antispasmodic drugs.” They are talking about prescription meds like dicyclomine and hyoscyamine , which lessen bad cramping and unusual colon contractions.
They may help more if you take them before you have symptoms. For instance, if you usually have pain or diarrhea after eating, itâs probably better to take them before a meal.
Low-dose antidepressants. If your doctor prescribes these, you may wonder how they could help you. Some may work because they weaken pain signals your gut sends to your brain. They can also improve diarrhea by slowing the flow of food through your stomach and intestines.
Anti-anxiety drugs. Your doctor might prescribe these if anxiety triggers your symptoms. Clonazepam , diazepam , and lorazepam can help take the edge off. Usually theyâre not used for a long time because of the risk of addiction.
Other prescription medicines. Three other options work in different ways to improve both diarrhea and belly pain in adults.
Remember to follow your doctorâs instructions exactly when taking any medication for your IBS-D.
Specific Treatments For Ibs Are Not Approved For Use
A small number of medications have been developed to treat IBS and have been shown to be effective in selected groups in clinical trials. These work on the interaction between serotonin and nerve cells of the colon. They include alosetron, cilansetron and tegaserod.
Safety concerns with these three medications has led to their withdrawal from the market, or restricted use only, and none are presently licensed in Australia. Microbiota altering therapies such as faecal microbiota transplantation are considered experimental and preliminary clinical studies have not shown this therapy to be clearly effective.
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Limit Fruit To Avoid Diarrhoea
This might go against every 5-a-day message thats been drilled into our brains, however, eating fruit at meals could make IBS symptoms far worse.
For those with IBS, the recommendation is to aim for no more than one piece of fruit per sitting, with up to three sittings across the day.
Many fruits contain a type of sugar that can increase water being drawn into the bowel and contribute to symptoms such as needing to rush to the toilet, bloating and diarrhoea, says Jo.
She also recommends limiting juices and smoothies, instead opting for whole fruit to give your gut microbes – the living bacteria in your gut – the maximum benefit of the plant fibres.
Ibs Vs Ibd: Know The Symptoms
Irritable bowel syndrome and inflammatory bowel disease may sound similar, but they are actually two very different health conditions with equally different treatment options. Together, they affect over 11% of the population – 0.8% of people experience IBD, while over 10% will experience IBS at some point in their lives.
But what exactly is the difference between IBS and IBS, and how can you tell for sure which one you have?
Knowing whether you have IBS or IBD can make all of the difference in how you recover from the gastrointestinal symptoms that are impacting your life.
This article will discuss the differences between IBS and IBD and how to use state-of-the-art testing to heal IBS and IBS using a functional medicine approach.
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I Learned To Be Open About It
Growing up, I thought that suffering in silence was my only real option. It didnt really seem appropriate to start discussing bowel habits in the school canteen, and I wasnt sure my friends would really understand what I was going through.
However, looking back, I wish Id found a way to broach the subject with a close friend, because having a sidekick who knew what was going on would have been a real help. Aged 18, I finally came out via a blog post, and the support was overwhelming. So many peers and fellow classmates had been suffering too. Id had no idea. People started approaching me at events to talk about their symptoms and how similar they were to mine.
Suddenly, I could breathe a sigh of relief that it wasnt my dirty little secret anymore. Its exhausting to keep it to yourself, so make sure you have someone you trust to confide in!
One of the biggest realities about IBS is the fact that, sometimes, you simply cant control it. And feeling out of control of your own body is extremely scary. Youre not sure whether its going to interfere with a date, ruin a social dinner, or disrupt a trip to the cinema.
But learning to live with that lack of control is the key to regaining control. Because living with IBS is often a catch-22. You worry about your symptoms flaring up, which invariably causes those symptoms to flare up.
How Is Ibs Diagnosed
If youve been having uncomfortable GI symptoms, see your healthcare provider. The first step in diagnosing IBS is a medical history and a physical exam. Your provider will ask you about your symptoms:
- Do you have pain related to bowel movements?
- Do you notice a change in how often you have a bowel movement?
- Has there been a change in how your poop looks?
- How often do you have symptoms?
- When did your symptoms start?
- What medicines do you take?
- Have you been sick or had a stressful event in your life recently?
Depending on your symptoms, you may need other tests to confirm a diagnosis. Blood tests, stool samples and X-rays can help rule out other diseases that mimic IBS.
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What Kind Of Healthcare Provider Best Treats Ibs Pain
A gastroenterologist who works in neurogastroenterology addressing the brain-gut axis, or a primary care doctor who knows how to work with chronic pain is usually best to treat IBS pain. They may work with a multi-disciplinary team of therapists. Finding and working with a patient-centered healthcare provider familiar with the concepts presented here will help ensure the best care for chronic pain and other symptoms of IBS.
Be on the alert for pain management clinics that use opioids as treatment, which are not a treatment for IBS and may worsen symptoms. Pain is the dominant symptom of IBS. Like all functional gastrointestinal disorders, IBS is a disorder of braingut interactions. The pain in IBS is related to a change in the part of the brain that receives signals from the gut, which turns up the volume on sensations. This understanding of the braingut connection is essential, not only to the cause of the chronic pain, but also to its treatment. There is no cure for pain in IBS. However, there are a few options that can reduce and control the pain. These include self management, psychological approaches, and medications. Opioids are not a treatment for IBS pain there is no evidence of long-term benefit. Finding and working with a patient-centered healthcare provider familiar with these concepts will help ensure the best available care for the chronic pain and other symptoms of IBS.