IBS Archives - Granite Peaks Gastroenterology of Utah

How Diet Affects IBS: Tips for Better Digestive Health

Posted on October 9, 2023December 27, 2024 by fuelmarketing

Irritable Bowel Syndrome (IBS) is a common digestive disorder affecting millions of people worldwide. Characterized by symptoms like abdominal pain, bloating, diarrhea, and constipation, IBS can significantly impact quality of life. One effective way to manage these symptoms is through dietary changes. We will delve into how diet influences IBS and provide actionable tips for better digestive health.

The Role of Diet in IBS

Trigger Foods

For many individuals with IBS, foods rich in fats, dairy, and certain types of carbohydrates—known as FODMAPs—can lead to symptoms. Other triggers might include spicy foods, alcohol, and caffeinated beverages. Identifying and eliminating these triggers can significantly improve IBS symptoms.

Foods to Include

A balanced diet for someone with IBS might include lean proteins, low-FODMAP fruits and vegetables, and whole grains. Incorporating foods rich in soluble fiber can also be beneficial in regulating bowel movements.

IBS-Friendly Diet Plans

Several diet plans are specifically tailored for individuals with IBS. These plans generally focus on low-FODMAP foods and include soluble fiber to aid in digestion.

The Low-FODMAP Diet

This diet restricts various types of carbohydrates that are difficult to digest and likely to ferment in the gut, causing gas and discomfort. The elimination phase removes high-FODMAP foods for a few weeks. Reintroduction occurs gradually to gauge tolerance levels.

The Mediterranean Diet

Although not designed for IBS, the Mediterranean diet is often well-tolerated. It emphasizes fruits, vegetables, lean proteins, and healthy fats, while limiting processed foods and sugars that might aggravate IBS symptoms.

Dietary Supplements and Probiotics

Some people find relief from IBS symptoms by incorporating dietary supplements and probiotics into their routine. Fiber supplements can help regulate bowel movements, while probiotics can balance gut flora. However, it’s crucial to consult a healthcare provider for personalized advice, as these supplements can also potentially worsen symptoms in some cases.

Monitoring and Adjustment

Managing IBS through diet can be a process of trial and error. It’s advisable to maintain a food diary to note which foods trigger symptoms and which offer relief. Over time, this can help tailor a dietary plan that minimizes discomfort and improves digestive health.

Dietary changes can have a profound effect on IBS symptoms. By identifying trigger foods and incorporating IBS-friendly diet plans and supplements, individuals can take significant steps toward better digestive health.

Struggling with IBS?

Are you struggling with IBS and need guidance from a medical expert? Reach out to us for a personalized consultation that can set you on the path toward better digestive health.

How to take care of your internal plumbing as you age

Posted on April 28, 2022December 27, 2024 by fuelmarketing

As we age, changes in our body often require change in our diet – not only what we eat, but how we eat it. A registered dietitian discusses some tips to keep your digestive health at its best as you age.

Jump To:

TIP: Eat your food hot

By Ginger Bailey, RDN CD

Originally posted on 11/24/2020
Updated on 4/28/2022

My kids get very upset when we use the “O” word. According to them, the word “old” is a dirty word and adults are not allowed to refer to themselves as such – especially not their grandparents!

No one likes to think about getting older or to even admit that they are aging. Unfortunately, “Time” cannot be denied and our bodies change as we age. The good news is that if we understand how our body changes and what we can do to support it, we can make age a state of mind more than a state of body. In essence, we can become wiser rather than simply older. (Shh, don’t tell my kids I said the “O” word!)

One of the best ways to keep our bodies fit and active as we age is to take care of our “internal plumbing.” I’m referring, of course, to our digestive system.

As we age, our gut becomes a little less efficient at extracting nutrients from the food we eat. Every vitamin and mineral we eat goes through a complex pathway to convert from food to a form the body can absorb. Some of these pathways are more complex than others. Generally speaking, the more complex the pathway, the sooner we tend to lose the ability to adequately absorb the nutrients we need. So, let’s talk about a few of these nutrients, as well as some things you can do to slow down the aging process and take good care of your internal plumbing.

Vitamin B12

Let’s start with Vitamin B12. This nutrient is an important powerhouse. It’s critical for your body to be able to convert the food you eat into energy. It also has one of the most complex absorption pathways. A low level of B12 is one of the most commonly-found deficiencies in seniors, and can lead to a condition called pernicious anemia. Pernicious anemia can cause significant fatigue, headaches, and paleness.

As people age, they often start feeling more fatigued and just chalk it up to “old age”. In some cases, it may be a nutrient deficiency that can be corrected. This is not the only deficiency that can cause fatigue, but it is one of the more common ones because B12 is difficult to absorb in any case. People that have had bariatric surgery or any surgery involving the stomach or small intestines are at high risk of being B12 deficient.

Fortunately, vitamin B12 levels can be checked. If you are experiencing any of the above symptoms, or are concerned, you can work with your doctor to have your blood levels analyzed and decide on the best support options for your body.

Trace Minerals

Trace minerals include calcium, magnesium, iron, zinc, selenium, copper, phosphorus, potassium, manganese, and a few others. These minerals are responsible for many things, including but not limited to: bone health, nerve conduction, and immune health. Most of these nutrients are absorbed in the first part of your small intestine, but many compete for the same absorption pathways. That can make it difficult for your body to digest all of them equally. For anyone who has had a surgery that altered the anatomy of their GI tract – and this is the case for many people – this can be an issue.

Also, as time goes on, it is common for our bodies to produce fewer digestive enzymes. Digestive enzymes help our bodies break down food and easily absorb nutrients, so this process can become less effective as we age.

There is a very simple solution to this problem. Eat slower! You see, chewing your food more can help with this. The more work your teeth do, the less your stomach has to do. There are also enzymes in your mouth that start breaking down food. So, if you chew your food more thoroughly, there is a higher likelihood that you are going to get more nutrients out of it. If your teeth are not in good condition, or chewing is difficult for some reason, then blending or pureeing food can also be helpful.

Fiber

Most Americans don’t get adequate fiber in their diets. This causes a myriad of problems. Consequences of inadequate fiber intake include:

Higher risk of cancers
More issues with constipation and diarrhea
Poor immune function
Higher cholesterol levels
More GI disturbances
Higher inflammation
Poor blood sugar control

The best sources of fiber are whole grains, vegetables, fruits, and legumes. If you aren’t getting enough fiber in your food, adding a fiber supplement can be helpful.

Age and Appetite

Many people find that their appetite decreases as they get older, often because of a reduced sense of taste. It can be harder to get those appropriate nutrients we just talked about when your appetite decreases and your sense of taste fades. So, what do you do then? Most people resort to dumping extra salt on their food so they can taste it. While that theoretically can work, it is not the best solution for your overall health. Instead, let’s talk about how to spice things up a bit!

(If you are thinking, “um…my digestive tract can’t party like I’m in my twenties anymore,” worry not. There are seasonings and spices that are both safe and healthy for your gut.)

Garlic is a very versatile flavor that is potent and has positive health benefits. Now, garlic can be an issue for some people with severe irritable bowel syndrome. For most people though, garlic is a great way to add a depth of flavor to food and make it more exciting to eat. Garlic pairs nicely with other flavors. It can also help decrease inflammation and support immune function.

Basil is another powerful herb that packs a lot of punch with flavor. It is very gentle on the digestive tract, but strong enough to add flavor to many types of foods. There are many varieties of basil. It is generally easy to grow even year-round inside your home. You can add a little or a lot depending on how much you like.

Rosemary is another one of my flavor rock stars. It tastes great with pork and many vegetables. It can really elevate a dish from “fine” to “delicious.” This one is also gentle on your insides, while allowing your taste buds to dance a bit.

There is one flavor source that requires a bit of caution. Anything containing capsaicin (the source of the heat you feel when you eat a spicy pepper) can be irritating to the digestive tract. While many people enjoy the heat, capsaicin has a higher tendency to cause digestive discomfort. Spices that contain capsaicin include, but are not limited to:

Red pepper flakes
Cajun seasoning
Some taco seasonings
Chipotle/jalapeno peppers

It doesn’t mean you can’t ever use these flavors, but you may want to use them in smaller quantities since they are potent and have the potential to irritate your gut.

Here’s another tip: Eat your food hot!

Warmer foods tend to be more aromatic. Much of our sense of tastes comes from our sense of smell. Foods that have a stronger smell are also usually easier to taste. If you find that tasting your foods is a problem, keeping your sinuses clear will help. Eating a hot sandwich might be easier to taste than if you ate it cold, for example. Or having cooked vegetables rather than raw.

Hopefully a few of these little tricks will help you enjoy your food longer and keep your body working at top notch for as long as possible. And maybe help you avoid feeling the “O” word for as long as possible. Happy eating!

Do you have concerns about your gastroenterological health? Granite Peaks Gastroenterology can help! Click here to request your appointment with one of our gastroenterologists today!

Stress and Your Digestive System

Posted on September 30, 2021December 27, 2024 by fuelmarketing

Today, it is all too common for people to feel unhealthy levels of stress. Stress has many negative effects on the body including high blood pressure, heart attack, abnormal heart rhythms and worsened irritable bowel syndrome (IBS) symptoms, among others. Great! Another thing to stress about! Don’t worry. Controlling your stress level can help you gain control of many other physical symptoms and help your body heal.

Your Brain’s Impact on Your Gut

Our digestive system has lots of nerves and is tightly connected with the brain. When your brain is communicating stress, anxiety and upset, your digestive tract is likely to follow its lead. This is why some people who experience prolonged, high levels of stress may develop worsened symptoms of their digestive conditions such as difficulty swallowing, diarrhea, constipation, increased acid reflux and worsened irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) symptoms. Gaining control of your stress by talking with specialists who can help you manage your symptoms is the next step.

Addressing Your Stress

Find the stress management tools that work for you. It may be meditation, music, exercise, meditation. Physical activity can release endorphins, which can boost your mental state and reduce the toll stress takes on it too. Eating foods that help reduce cortisol, a stress hormone, such as salmon, almonds, foods high in magnesium, and vitamin c are a few options to try.

Consider talking to a mental health specialist who may be able to help you reframe your thoughts to see things in a more positive light. Learn new life skills to help you manage areas that are chronic stressors for you.

Your Stress is Under Control

If you’re not stressed and you have digestive symptoms like the ones mentioned above, it’s time to talk to a gastroenterology specialist who can pinpoint the cause of your issues. At Granite Peaks Gastroenterology, they will carefully consider your symptoms to find the solution, helping find the relief you need to feel better and achieve your best health.

Adjust Expectations During Shelter in Place

Posted on April 9, 2020December 27, 2024 by Granite Peaks

Granite Peaks GI Staff

4/09/2020

Part of the frustration that can come with this sort of change to our normal daily life is sustaining our normal expectations while living and working in an abnormal way. This goes for how we work, how we eat, how we exercise, how we create, sleep and plan. The secret to avoiding some of the frustration is to adjust our expectations – for now.

If you’re working reduced hours whether at home or at your place of work, you are likely able to adjust your schedule and some expectations. This is a great opportunity to build some new, positive habits by planning ahead to use your time wisely and productively.

Awaken at the same time. Try to keep it around your usual time so there won’t be a big adjustment when you go back to work full-time.
Use your commute time. If you aren’t commuting, use the extra time to ease into your morning with 10-30 minutes of exercise, meditation, reading, and a healthy breakfast. No, you can’t go to the gym right now, but you can figure out some ways to keep up some of your routine from home. Meditation (look online for free options for guided meditation) can help create mindfulness and ease anxiety during this unusual time.
Take a break from at-home work. If you’re used to grinding through the workday without breaks, rethink that. A break gives your mind and body the reprieve it needs. Those with children or family at home can use the time to reconnect with them and enjoy each other’s company. Have lunch outdoors on good-weather days to recharge and ready yourself for the afternoon’s work. That’s better than the work lunchroom any day!
Adjust expectations of your kids. If you have kids, you know this time has been tough on them and on you. They’re not in their normal routine, they can’t see their friends, they can’t even go to the playground at the park. That’s a recipe for tension and mayhem. So, you’re it! You’re in charge of their schooling, daycare, mind-filling and energy-burning activities – while you’re trying to work from home. Create a schedule of activities including learning, chores, creative play, outdoor and nap/quiet times. If you need to discuss adjusted work hours/expectations with your supervisor to accommodate this unusual situation, do it. Check the Workforce Services website if you have questions about your rights or eligibility for benefits surrounding daycare and your work hours.
If your work hours are over earlier than usual, plan to get outdoors for some exercise and fresh air, start a project you’ve been waiting to do, catch up on correspondence and reading, and remember to play. Make a list and schedule certain days or times for certain activities. Planning is key to making the most of your time at home the same way it is at work.
Eat healthy. Now is the time to learn how to properly meal-plan and shop for only those things you need to make your week’s meals. It’s not the time to indulge (too much) with unnecessary, unhealthy items. There are online planning tools to help you build a healthy, delicious week of meals. Remember to wear your facemask at the store and wash your hands thoroughly before and after you shop.
Adjust your TV consumption. Don’t overdose on news about the pandemic. Get one daily news report and move on to entertaining or educational programming. Choose the time you will stop watching television and begin winding down for a reasonable bedtime to allow for 8 hours of rest. Rest is an important part of staying healthy. This is an easy one – you can do it.
Shut off the TV. Even better! Now is a great to play games, work puzzles or work on projects alone or with your family. This is an adjustment that you can enjoy living with.

For those with digestive health issues, be sure to stock up on the items that keep you feeling healthy and keep your digestive system running smoothly. Whether you have celiac disease, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), or other digestive health issues, be sure you are taking the precautions necessary to stay well. If you are immunocompromised, do what you can to minimize your risk of contracting the virus. Plan daily exercise and dietary goals for staying well.

Know that your providers at Granite Peaks Gastroenterology are available to you, even during the COVID-19 situation. We have telehealth appointments available that let you connect with your GI provider from the safety and privacy of your home. It’s easy to set up, convenient and safe!

For those who have symptoms that may necessitate an in-person appointment, our clinic is making it safe for you to come in to see us. We are scheduling patients to allow for social distancing, pre-screening patients, performing extra cleaning steps between patients and wearing personal protective equipment.

For now, we are all adjusting expectations and actions to stay well and avoid either contracting COVID-19 or spreading it to others, and it’s working. Keep up the good work, Utah! We wish everyone safe and healthy days ahead.

Treating IBS with Cognitive Behavioral Therapy

Posted on January 8, 2019December 27, 2024 by Christopher Cutler

By Christopher Cutler, M.D.

Irritable bowel syndrome (IBS) affects 10-15% of adults in the United States. It is a functional disorder of the gastrointestinal tract characterized by abdominal pain and altered bowel habits. IBS is usually treated with dietary modifications and medications directed at underlying symptoms (diarrhea, constipation, abdominal pain, bloating). Patients may also receive benefit from antidepressants, probiotics, and antibiotics. But what about patients with refractory symptoms that do not respond to traditional therapies? What are their options? One promising alternative to consider is cognitive behavioral therapy (CBT). CBT is a short-term therapy (4-10 one hour sessions with a therapist) that focuses on modifying behaviors and altering dysfunctional thinking in hopes of improving mood and GI symptoms.

The Brain-Gut Connection

In patients with IBS, there is dysregulation of the gut brain axis, a complex neurologic communication between the brain and GI tract. Stress and psychological factors can directly influence gut function via this pathway, contributing to IBS symptoms. Patients with IBS have an increased tendency to experience pain in response to normal bowel function. This may be attributed in part to abnormal pain processing in the brain. People affected by IBS also have a fear of bowel symptoms and associated avoidance of situations where symptoms may occur. It is a vicious cycle since symptoms themselves become a stressor, and this anxiety contributes to increased gut pain sensitivity and altered motility causing worse GI symptoms and worse anxiety.

Given the importance of brain-gut interactions in IBS, psychological interventions are an effective option for this condition. These modalities may include cognitive behavioral therapy, hypnotherapy, and mindfulness. CBT has been the most extensively studied with more than 20 published randomized clinical trials showing relief of IBS symptoms in 50-70% of patients. These benefits are frequently maintained for up to one year after therapy.

Treating IBS with CBT

CBT involves relaxation strategies such as specialized deep breathing. This increases the patient’s awareness of the connection between distorted thinking patterns, stress, and digestive symptoms. CBT also helps patients develop coping strategies by encouraging them to shift from a solution-focused approach to a self-management approach to deal with this chronic condition. CBT also uses exposure techniques which involve facing situations the patient avoids because of fear of symptoms. With time, avoidance behaviors decrease and the thought of symptoms being harmful is reduced.

The American Gastroenterology Association recommends psychological interventions for patients with moderate-to-severe IBS who do not respond to standard medical therapies, and for patients for whom psychological factors exacerbate their symptoms. CBT is an effective treatment option for patient with IBS, and its use to treat this disorder is becoming more widely accepted. The physicians at Granite Peaks are experts in the diagnosis and therapy of IBS and are eager to help you. Please call us to discuss traditional and alternative strategies to help you manage your IBS symptoms.

Are you Lactose Intolerant?

Posted on January 25, 2018December 27, 2024 by

OVERVIEW
Lactose is the sugar found in milk and dairy products such as cheese and yogurt. After eating dairy products that contain this sugar, usually lactase, a digestive enzyme of the small intestine, helps to breakdown this complex sugar into two simple sugars, glucose and galactose. These simple sugars are then absorbed in the small intestine and ultimately reach the blood stream where they act as nutrients. The enzyme lactase is located in the lining of the small intestine known as the intestinal villi.

In addition to milk and dairy products such as ice cream, yogurt and cheese, lactose can be found in bread and baked goods, processed breakfast cereals, instant potatoes, some soups and non-kosher lunch meats, candies, dressings and mixes for pancakes and biscuits. Lactose is also the sugar found in breast milk and standard infant formulas. Therefore almost all babies are able to digest and absorb this sugar and it serves as their primary dietary sugar.

SYMPTOMS
Because lactose is not digested properly in the small intestine of individuals who are lactose intolerant, it passes whole into the large intestine or colon. Upon reaching the colon it is broken down by the normal colon bacteria. This breakdown results in the production of carbon dioxide and hydrogen gases. The gas production can lead to the following common symptoms:

• Abdominal distension and pain
• Excess burping
• Loud bowel sounds
• Excess gas and diarrhea following ingestion of lactose.
• Watery and explosive bowel movements
• Urgency with bowel movements, which means that children feel that they have to get to the bathroom immediately or they will have an accident.

The symptoms of lactose intolerance can start during childhood or adolescence and tend to get worse with age. The severity of symptoms is usually proportional to the amount of the milk sugar ingested with more symptoms following a meal with higher milk sugar content.

Although eating lactose-containing products will result in discomfort for someone who is lactose intolerant, they are not at risk of developing more serious intestinal disease because of long-term lactose malabsorption. The only exception to this would be for babies who are born with primary lactase deficiency or children with secondary lactase deficiency as discussed below.

CAUSES
Primary Lactase Deficiency: This condition is very rare and occurs when babies are born with a deficiency or absence of the enzyme lactase. Babies inherit this condition by getting one gene that causes this problem from each of their parents, even though both parents may be lactose tolerant. These babies require a specialized formula with another type of sugar such as sucrose (present in table sugar), which they are able to digest.

Secondary Lactase Deficiency: The most common cause of temporary lactose intolerance in infants and young children is infection that affects the gastrointestinal tract and can damage the lining of the small intestine.

Rotavirus and Giardia are two common organisms that cause damage to the surface of the small intestine resulting in temporary lactose intolerance. Older infants and young children will commonly be infected by a rotavirus. The symptoms of rotavirus infection symptoms include vomiting, diarrhea (frequent, watery stools), and fever. Giardia is a parasite that is found in well water and fresh water from lakes and streams. Treatment of giardia infection with antibiotics will resolve the lactose intolerance.

Secondary lactase deficiency can also be due to Celiac disease, which is intolerance to gluten, the protein found in wheat, rye, barley and other grains. Crohn’s disease, an inflammatory condition that can affect any part of the gastrointestinal tract, can lead to secondary lactase deficiency as well. Once each of these conditions is treated, the lactase deficiency will resolve. The lactose intolerance usually resolves within three to four weeks when the lining of the intestines returns to normal.

Acquired Lactase Deficiency: Many individuals acquire lactose intolerance as they get older. It is estimated that approximately one-half of adults in the United States have acquired lactase deficiency. This condition is due to a normal decline in the amount of the enzyme lactase present in the small intestine as we age. Although lactose is an important part of the diet in infants and young children it represents only 10% of the carbohydrate (sugar) intake in adults. However, individuals who are lactose intolerant may not be able to tolerate even small amounts of this sugar in their diet.

Lactose intolerance occurs more frequently in certain families. One of the most important factors affecting the rate of developing lactose intolerance is an individual’s ethnic background. Approximately 15% of adult Caucasians, and 85% of adult African Americans in the United States are lactose intolerant. The rate of lactose intolerance is also very high in individuals of Asian descent, Hispanic descent, Native Americans and Jewish individuals.

DIAGNOSIS
Lactose intolerance is diagnosed by a simple test called a hydrogen breath test. After an overnight fast before the test, an individual breathes into a bag and then drinks a specified amount of the milk sugar in the form of a syrup. In adults this corresponds to the amount of milk sugar in a quart of milk. Subsequent breath samples are taken for up to three hours. The breath that they exhale into the bag is analyzed to determine its hydrogen content. During the course of the test individuals who are lactose intolerant will have an increase in the amount of hydrogen that they exhale. If the values for hydrogen increase above a certain value, the diagnosis of lactose intolerance is made. Patients who are lactose intolerant may also develop their typical symptoms during the test.

In younger children or in children who cannot tolerate the breath test, removal of lactose from the diet and possible supplementation with lactase can be done for 2-4 weeks to see if this improves the symptoms.

Treatment
The best treatment of lactose intolerance is a combination of dietary modification and taking a supplement to aid in digestion of lactose. Individuals who are lactose intolerant should meet with a dietician to review the sources of lactose in their diet. Some reduction in the daily lactose consumption is usually required. When an individual is going to be eating a food that contains lactose they should take a commercially available non-prescription lactase supplement at the time of lactose ingestion. This type of supplement can be taken throughout the day whenever lactose is ingested. Some individuals will be less lactose intolerant and therefore will be able to tolerate comparatively larger amounts of lactose. Alternatives to milk for lactose intolerant individuals include products such as soy milk. If an individual is restricting their milk/ dairy intake it is important to ensure adequate supplementation of calcium and Vitamin D in the diet. This is especially important for pediatric patients and women.

Recommended daily calcium intakes:
1-3 years of age: 500 mg
4-8 years of age: 800 mg
9-24 years of age: 1300 mg
Age 25 and above: 800-1000 mg
Pregnant and nursing women: 1200 mg

Author(s) and Publication Date(s)

Marsha H. Kay, MD, The Cleveland Clinic, Cleveland, OH, and Anthony F. Porto, MD, MPH, Yale University/Greenwich Hospital, Greenwich, CT – Updated December 2012.

Marsha H. Kay, MD, The Cleveland Clinic, Cleveland, OH, and Vasundhara Tolia, MD, Children’s Hospital of Michigan, Detroit, MI – Published September 2004.

Diagnosing and Treating Irritable Bowel Syndrome (IBS)

Posted on April 11, 2017December 27, 2024 by J. David Schmidt

By J. David Schmidt, M.D.

Irritable Bowel Syndrome (IBS) represents a group of symptoms that cause a significant number of people to seek medical attention every year. It is estimated that 10-15% of North Americans suffer from IBS, and it is by far the most commonly diagnosed gastrointestinal condition. Irritable Bowel Syndrome is the second most common medical reason to miss work, after the common cold.

The specific symptoms of IBS vary widely among those who suffer from the condition, but the hallmark is a pairing of chronic abdominal pain and altered bowel habits. The abdominal pain may range from mild to severe. It may be associated with factors such as stress and eating. The bowel changes may include diarrhea, constipation, or alternating back and forth between both. There is also a sub-type called post-infectious IBS that develops after a gastrointestinal infection. According to the most current literature, IBS is defined as recurrent abdominal pain at least one day per week in the last three months, on average, and associated with two or more of the following:

- • Improvement with bowel movements

- • Associated with a change in stool frequency

• Associated with a change in stool form or appearance

The following symptoms are NOT consistent with IBS and are reasons to see a gastrointestinal specialist:

- • More than minimal bleeding

- • Weight loss

- • Iron deficiency anemia

- • Nocturnal symptoms

• Family history of colorectal cancer, inflammatory bowel disease, or Celiac sprue

The initial treatment of Irritable Bowel Syndrome includes dietary modifications such avoiding foods that contain lactose and gluten, as well as gas-producing foods. A low FODMAP diet is also a consideration as initial therapy. Pharmacologic (drug) therapy for IBS depends upon the troublesome symptoms. IBS with constipation is treated with increased dietary fiber as well as psyllium and prescription laxatives. IBS with diarrhea can be treated with OTC anti-diarrheal medications such as Imodium. Other options include prescription medications such as bile acid sequestrants and serotonin receptor blockers. Gas and bloating can be treated with antispasmodic medications. or even GI-selective antibiotics.

Due to the many different symptoms of IBS, there is a wide range of treatment options including dietary, behavioral, and medical therapies. It is important to discuss your symptoms and family history with your medical provider so that appropriate evaluation may take place. Ultimately, IBS is a very common but treatable condition.

Learn more about Irritable Bowel Syndrome (IBS) or click here to schedule an appointment with a Granite Peaks gastroenterologist.

More Options To Treat Irritable Bowel Syndrome

Posted on June 23, 2016December 27, 2024 by fuelmarketing

By Peter Loftus

View Original Article

People suffering from a common but tough-to-treat gut disorder called IBS are discovering a growing set of treatment alternatives.

The U.S. Food and Drug Administration has approved two new drugs in the past year for the disorder, known as irritable bowel syndrome, which involves chronic diarrhea, constipation or both, along with abdominal cramping. It is estimated to affect about 12% of Americans, more often women than men and typically in people younger than 45, according to the Mayo Clinic.

Meanwhile, a diet dubbed “Low Fodmap,” which originated in Australia more than a decade ago, has spread in the U.S. in recent years. It is gaining acceptance from gastroenterologists and dietitians as some small clinical trials bolster evidence of its effectiveness in reducing IBS symptoms. The diet eliminates or reduces foods with certain types of sugars that have been found to trigger symptoms.

“I definitely think the options are better and that patients with mild symptoms can do better,” says Dr. Lin Chang, director of the digestive health and nutrition clinic at UCLA‘s David Geffen School of Medicine. “I think the question is, what treatment do you use in what patient?”

Unlike more serious gut conditions, such as Crohn’s disease or ulcerative colitis, IBS doesn’t alter bowel tissue or put patients at increased risk for colorectal cancer. But it causes pain, embarrassment and anxiety in sufferers, who often limit their activities only to places where a toilet will be close by.

“It’s really common, and I think it’s underappreciated in terms of the burden it creates for affected individuals,” says Dr. William Chey, a professor of internal medicine specializing in gastrointestinal disorders at the University of Michigan.

Older treatment options have included antispasmodic drugs like dicyclomine and low-dose antidepressants such as amitriptyline. Dietary approaches have included adjustments to fiber intake. But these options don’t work for everyone.

In May 2015, the FDA approved two new drugs for treatment of IBS in which diarrhea is predominant: Viberzi, made by Allergan PLC, and Valeant Pharmaceuticals InternationalInc.’s Xifaxan. For IBS with constipation, the FDA approved Allergan’s Linzess in 2012.

Dr. Leslie Yang, a University of Chicago gastroenterologist, says the new drugs have shown some level of efficacy in clinical trials, but it can take some trial and error to figure out which will work best for an individual patient. “It’s more of an art than a science,” she says.

The new drugs aren’t without side effects. Viberzi can increase the risk for muscle spasms near the digestive tract that can lead to inflammation of the pancreas. Dr. Chang of UCLA says doctors should avoid prescribing it to people who abuse alcohol.

A dietary approach to easing that burden has gained steam in the U.S. as physicians like Dr. Chey listen to patients who would rather avoid taking a prescription drug, he says. The University of Michigan, University of Chicago and Stanford University are among the academic medical centers that have embraced the low Fodmap diet as an option for patients. Some have hired dietitians specializing in gastrointestinal disorders to help guide patients.

Fodmap is an acronym for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols”—a group of sugars and other food ingredients poorly absorbed in the gut. Patients are advised to restrict eating foods with high amounts including asparagus, apples, cow’s milk and certain beans. They are encouraged to eat foods with lower amounts, including zucchini, bananas, certain cheeses and gluten-free breads and cereal.

“This helps to at least minimize the diarrhea, minimize the gas and bloating,” says Lori Welstead, a University of Chicago dietitian. “So this can really help with the quality of life for patients.”

Researchers at Monash University in Melbourne, Australia, developed the low-Fodmap diet and have conducted clinical trials to test its efficacy. In a 38-person study, those on the low-Fodmap diet had reduced gastrointestinal symptoms versus those on a typical Australian diet, according to results published in the medical journal Gastroenterology in 2014.

In a U.S. study of 33 children with IBS conducted by researchers at Baylor College of Medicine in Houston, a low-Fodmap dietreduced the frequency of abdominal paincompared with a traditional American diet, according to results published in Alimentary Pharmacology and Therapeutics last year.

Morgan Blenkhorn, a 21-year-old student at Grand Valley State University in Allendale, Mich., says the low-Fodmap diet has given her relief from severe IBS symptoms. She first started having problems after a food-poisoning incident in high school. Her anxiety about having to use the bathroom frequently kept her from many activities including graduation parties, she says.

She discovered the low-Fodmap diet after visiting Dr. Chey at the University of Michigan in 2013, and it has vastly reduced her symptoms, she says. Last summer she taught English in the Netherlands and made a side trip to Germany—something she would never have considered when her IBS was worse.

“It changed my life completely,” she says. “I don’t think that I could have even gotten this far in college without drastic change.”

A caveat with the low-Fodmap diet: There is emerging evidence that it alters the diverse population of microbes in the gut. This could have long-term implications, because some gut microbes are believed to have health benefits. A Monash-sponsored study of 33 people found that the low-Fodmap diet reduced abundance of bacteria in the gut, according to results published in the medical journal Gut in 2014.

Emma Halmos, a dietitian at Monash who helped conduct the study, says more research is needed to show whether the microbial alterations can harm health. She says it underscores the need for healthy people to avoid the low-Fodmap diet, and for patients on the diet to try to reintroduce specific foods if they don’t trigger symptoms.