10 Things Your Primary Care Doctor Does That Should Make You Run for the HillsWe have all been through the launch of expensive medications like Zelnorm for Irritable bowel syndrome only to then see them pulled from the market, making all of us skeptical that anything works. Most patients with irritable bowel syndrome are managed by primary care doctors and there is an ongoing search for effective treatments that are safe, inexpensive and readily available. So, what works? This question was asked and answered in a recent systematic review of the literature published in the December 13, 2008 British Medical Journal. When other causes for your abdominal pain, diarrhea and/or constipation are ruled out and you receive a diagnosis of IBS you want to know what remedies really work.
Fiber: Twelve studies using fiber for treatment of the irritable bowel symptoms were reviewed and found fiber to be effective. Symptoms were relieved in those taking fiber as compared to placebo or no treatment. Importantly, the benefit was limited to studies of ispaghula (psyllium). Psyllium (Fiberall, Metamucil) is easily available as a powder you can add to your drink. Does it work to improve symptoms? Yes, in the many studies on psyllium persistent symptoms were reported by 52% of patients assigned to psyllium versus 64% of those assigned to placebo.
Antispasmodics: After reviewing 22 trials the investigators found that antispasmodics did reduce symptoms compared to doing nothing or placebo. Of the many different antispasmodics evaluated, those showing consistent efficacy were otilonium (otilonium bromide or OB), and hyoscine (Buscopan).
Peppermint Oil: Perhaps the most surprising findings were that analysis of four trials on peppermint oil found that it was effective for the treatment of IBS. Watch it here because Peppermint oil is known to worsen heartburn symptoms so it does come in enteric coated capsules. Peppermint oil is especially effective in reducing flatulence and abdominal pain and distension. A benefit is seen using peppermint oil for the treatment of IBS symptoms over placebo.
Is there a perfect cocktail for IBS? Discuss this with your doctor but it’s looking like psyllium, antispasmodics (preferably hyoscine), and peppermint oil make sense as first line treatment for the irritable bowel syndrome.
Your experience?
Dr O.
:
10 Symptoms you can't ignore
Be sure to go to a well respected, licensed dr., however. Mine is an MD, also.
Try eliminating gluten from your diet (it's pretty tricky) and see if things improve a lot. It's worth it! Or, even better, talk to your doc about it.
Search through my previous blogs (click on view all articles by Dr Orrange) where I discuss probiotics....
Dr O.
Alice krieger
al67
It wasn't until I finally got my PTSD diagnosis, and 3 Pdoc's later that someone addressed my IBS issues, as it most likely stems from my PTSD.
My Pdoc prescribed me Librax, a combo of an older Benzodiazepine and anti-spasmodic --chlordiazepoxide/clidinium-- This has really helped my IBS symptoms! It works for me! :)
And I only get heartburn rarely since avoiding those foods that trigger it.
An approach initially is to take insoluble fiber and soluble fiber blend. One can get cyclical diarrhea and constipation with only insoluble fiber due to the irritation to the bowel with the roughage. Starting with a larger % of insoluble fiber which acts like a gentle push of the food through the system without irritation with a little insoluble fiber. Over time, if possible you can titrate a more higher % of more insoluble fiber to soluble fiber ratio. Both have different functions and each system will respond to certain approaches. Prima Yerba is a great product which combines both soluble and insoluble fiber, but higher on soluble fiber and gently gets things going in the right direction gently. With many of these approaches there are about 50% of the population where the products do not help.
Prima Yerba and enteric coated pepermint oil with real organic pepermint tea( anti spasotic properties and fennel( reduces bloating) really help and made with a frech press and hot water to make large amount of tea. Arcacia powder is an organic tasteless all soluble fiber product and is a totally soluable fiber natural product which could be used exclusively as a supplement to give only insoluble fiber initially, then graduate to Prima Yerba mixture in capsules or powder. this approach can possible help the other 50% or more that the products mentioned do not work and cause and increase in painful intestinal problems.
Starting with this approach first will cause no problems and needs to be adhered to for a while before working well. It never causes problems and only could help. all of these products can be either purchased in totally organic form in good health food stores and http://www.helpforibs.com/ is a great website with this approach and works with all natural and organic products.
As far as an antispasmotic goes, bizmuth chloride with is the active ingredient in pepto bismol function is to reduce the spasms in the intestine espeically during diarrhea episodes and is an otc and has been around for years reducing spasmotic peristalsis which is the wave like motion in the intesting to drive waste to the large bowel and colon. So if you have diarrhea and take and antidiarrheal( I call a chemical cork) then you can have rebound constipation and create a vicious cycle. Bizmuth choride is very gentle and can reduce the spasms of your intestines and colon enough to create a gentle reduction in spasms that cause IBS like symptoms to be reduced in a painful acute problem.
The problem with some products from health food stores tht stimulate the colon to increase peristalsis, it can trigger a cyclical prolems just like medical stimulants to increase digestive action. This can be problematic if the colon is already in a dysfunctional spasmotic action causing the slowing of waste through the system and it can get stuck and casue toxins to be realeased into the body due the this waste sitting there in the colon and intestine and act like a toxic sepsis of a sort and cause pain in the body in the joints and other general pain which can cause fibromyalgia and chonic fatique symtoms for may as these toxins cause swelling and irritation in the body which can manifest itself ans bloating, swollen joints, general malaise, etc.
Lastly probiotics are exremely important to crowd out the bad bacteria that develops due to this toxic waste that can stay in the intestine and colon for long periods of time. This product can keep a good level of good bacteria to crowd out the bad bacteria and its toxins. It is a numbers game. The more good bacteria overwhelm the bad bacteria and create a more normal healthy environment for the colon to be in a non-toxic healthy state. Jarodophillus is a high quality organic product that is enteric coated that has a large number of several strains of the good bacteria probiotics and does not need to be refrigerated. The advantage of multiple strains of cultures of bacteria is that some systems have a deficit of one of these organisms or another. Ultimate flora by renew life has the largest numbers of cultures in the greatest amounts, but needs to be refrigerated.
So,as a summary:
-a high blend of soluble fiber and slowly adding insoluble fiber( read the labels) like organic arcasia tasteless powder and graduating to organic Prima Yerba with a combo of insoluble and soluable fiber.
-peppermint and fenel organic tea made fresh with a french press calms the intestine and reduces spasms. It tastes really good too. Enteric coated pepermint oil reaches the large instestine and colon without being destroyed by the acidic stomach.
-high quality enteric coated probitiotic to work on the intestines and colon to create the proper amount of good bacteria to reduce toxins from bad bacteria
pepto bismol( bizmuth chloride can alleviate spasmotic as an otc remedy
herbal formulas that relax the colon and intestines and stay away from herbal products that increase spasms as stimulus to peristalis.
Consult your doctor always. Most will be open to this organic and whole food approach and can help you supplement this this medication if necessary for spasms of the colon. This is a different approach in the fact that you try to reduce the spasms and start with soluble fiber first as opposed to starting with insloluble fiber which is suggest always as the first approach. It can be blended in later in your cocktail of helpful products by your doctor's help. The doctor must have a good working knowledge in this area and be open to logical alternative treatment regimens.
Good luck,
chris reynolds writespect@aol.com
Nancy