Irritable bowel syndrome - aftercare

Diet

Dietary changes can be helpful. However, no specific diet can be recommended for everyone with IBS. This is because the condition differs from one person to another. The following changes may help:

Foods can make your symptoms worse. You may need to keep a diary, writing down what you have eaten and the symptoms you're having. Look for a pattern that may suggest certain foods make your symptoms worse. Foods that often cause IBS symptoms are:

• Fatty foods, such as French fries and other fried foods
• Dairy or milk products
• Coffee and any drink with caffeine. Caffeine can stimulate the intestines.
• Sodas, alcohol, or chocolate
• Wheat, rye, or barley

Eating large meals can worsen symptoms in some. Switching to 4 - 5 smaller meals a day may improve or relieve your symptoms.

Increasing fiber in the diet often helps symptoms of constipation. Fiber is found in whole grain breads and cereals, beans, fruits, and vegetables.

Since fiber may cause gas, it is best to add foods with fiber a little bit at a time in order to let your body become used to them.

Medications

No one medication will work for everyone. Medications your doctor might suggest that you try include:

• Anticholinergic medications taken about a half-hour before eating to control colon muscle spasms and abdominal cramping
• Antidiarrheal medications such as loperamide
• Laxatives, such as lubiprostone, bisacodyl , and other ones bought without a prescription
• Low doses of tricyclic antidepressants to help relieve pain or discomfort
• Rifaximin, an antibiotic that is not absorbed from your intestines

It is very important to follow your doctor’s instructions when using medicines for irritable bowel syndrome. You should not take a different amount or take the medicine either more or less often than your doctor said to. Doing so can lead to further problems.

Stress

Stress may cause your intestines to be more sensitive and squeeze or contract more. Many things can cause stress. What is stressful to one person may not be stressful to another. Some sources of stress may be:

• Not being able to do activities because of your pain
• Other medical problems
• Changes or problems at work or at home
• Having a busy schedule
• Spending too much time alone

A first step in reducing your stress is to figure out what makes you feel stressed. Ask yourself:

• What do you worry about most?
• Do you always have something on your mind?
• Is something in your life making you sad or depressed?

Keep a diary of the experiences and thoughts that seem to be related to your anxiety. Are your thoughts adding to your anxiety in these situations?

Reach out to other people. Find someone you trust (such as a friend, family member, neighbor, or clergy member) who will listen to you. Often, just talking to someone helps relieve anxiety and stress.

When to Call the Doctor

You should contact your doctor if you develop fever, gastrointestinal bleeding, severe pain that does not go away, or unintentional weight loss of over 5 - 10 pounds.

Alternate Names

IBS - aftercare

References

Irritable bowel syndrome. NIH Publication No. 07-693. September 2007. The National Digestive Diseases Information Clearinghouse (NDDIC).

Talley NJ. Irritable bowel syndrome. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 118.

Update Date: 8/21/2011

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.