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Irritable Bowel Syndrome

more about Irritable Bowel Syndrome

  • This is a disorder in which the colon does not function properly. There is no known underlying medical cause. This condition usually begins in the late teens or early 20s.

  • Abdominal pain -- crampy lower abdomen
  • Abdominal pain relieved by bowel movements
  • Increased stool when abdominal pain starts
  • Diarrhea or Constipation or fluctuation between both of these
  • Abdominal Bloating
  • Anxiety may be present
  • Depression may be present

  • Examination:

- May have abdominal tenderness

  • Exclude other causes (ulcerative Colitis or Ovarian Cancer). Blood tests and sigmoidoscopy/colonoscopy are often performed. Pelvic Ultrasound may be performed in women.

  • Diet:
    1. Trial of lactose-free diet
    2. Sorbitol, a common sweetener used in sugar-free dietetic foods, often causes Bloating and Diarrhea. Foods containing Sorbitol should be eliminated.
    3. Fructose, a sugar used in some health foods, can cause abdominal discomfort.
    4. Avoid flatulence ("gas") producing foods (beans, brussel sprouts, cabbage, cauliflower, raw onions, plums, grapes, raisins, red wine, beer, and coffee).
    5. Eliminate caffeinated beverages, such as coffee, sodas, and tea.
    6. A trial of psyllium hulls (Metamucil) helps some individuals.
    1. Use of antiDiarrheal agents before stressful situations (e.g., social events) -- Lomotil or Imodium commonly used
    2. Lotronex is a new medication that helps with abdominal pain and Diarrhea in women patients only.
  • Abdominal spasm:
    1. Anticholinergic agents such as hyoscyamine or dicyclomine
    2. Lotronex for female patients only

- Trial of Metamucil as described above. A Trial of other fiber products such as bran or methylcellulose.

  • Abdominal pain:

- Antidepressants such as Amitriptyline (Elavil) help and may also help with Diarrhea symptoms (avoid in individuals with chronic Constipation as it may make worse).

  • Other considerations:

- Behavioral techniques and psychological evaluation and treatment may help some individuals.

more about Irritable Bowel Syndrome

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