What treatments are available for irritable bowel syndrome?

Firstly, the diagnosis may provide reassurance that there is no other serious problem. There is no single treatment that will cure all symptoms or all patients. Treatment will depend on your symptoms. Correction of a poor quality diet may resolve IBS particularly when the diet is lacking in fibre. Excess caffeine and alcohol should be removed from your diet. You may be aware that certain foods exacerbate your symptoms and these should be avoided.

Codeine phosphate is a moderately strong painkiller that has a role in the management of diarrhoea. It may have a place occasionally when diarrhoea predominates in IBS.

Anti-spasmodic agents reduce the smooth muscle activity of the bowel; they are usually taken before meals. Mebeverine (Colofac MR Solvay) one tablet three times daily, and peppermint oil (Colpermin Pharmacia and Upjohn) one or two capsules three times daily are well tried preparations. Kolanticon (Peckforton) has the antispasmodic dicyclomine in combination with the antacid, aluminium hydroxide, and dimethicone, an antiflatulent; 2 to 4 teaspoonfuls four hourly is the recommended dose.

The effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome has been reviewed in a meta-analysis undertaken in Canada.0801 Randomised controlled trials comparing fibre, antispasmodics, and peppermint oil with placebo or no treatment in adults with irritable bowel syndrome were eligible for inclusion. The minimum duration of therapy considered was one week, and studies had to report either a global assessment of cure or improvement in symptoms, or cure of or improvement in abdominal pain, after treatment. Fibre, antispasmodics, and peppermint oil were all more effective than placebo in the treatment of irritable bowel syndrome.

There have been suggestions that Candida (thrush) may be a factor in IBS. Scientific studies, however, have not shown any consistent relationship between Candida and IBS so that dietary measures to reduce Candida seem to be without foundation.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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