Fiber, pro­bi­otics can re­lieve ir­ri­ta­ble bowel symp­toms

Daily Freeman (Kingston, NY) - - YOUR DAILY BREAK - An­thony Ko­maroff Ask Dr. K

I have ir­ri­ta­ble bowel syn­drome with al­ter­nat­ing con­sti­pa­tion and di­ar­rhea. Will eat­ing more fiber help? What about pro­bi­otics or other non-med­i­cal treat­ments?

Ir­ri­ta­ble bowel syn­drome (IBS) is a com­mon in­testi­nal dis­or­der with many un­pleas­ant symp­toms. Many peo­ple with IBS go back and forth be­tween di­ar­rhea and con­sti­pa­tion, with pain and bloat­ing in be­tween. Oth­ers al­ways have di­ar­rhea or con­sti­pa­tion.

Un­for­tu­nately, there is no cure for IBS. How­ever, there are a num­ber of things you can do to im­prove your symp­toms.

Adding fiber to your diet can help re­lieve con­sti­pa­tion. Fiber in­creases the stool’s bulk and speeds its move­ment through the gas­troin­testi­nal tract. It may also ease ab­dom­i­nal pain, and even im­prove di­ar­rhea.

You can in­crease the fiber in your diet by eat­ing whole grains, bran ce­re­als and plenty of fresh fruits and veg­eta­bles. You can also try a fiber sup­ple­ment con­tain­ing psyl­lium or methyl­cel­lu­lose.

When in­tro­duc­ing fiber to your diet, do so grad­u­ally. Too much, too fast can cause ex­ces­sive gas, cramp­ing and bloat­ing. Drink lots of wa­ter or other liq­uids. And be aware that for some peo­ple, a high-fiber diet may in­crease bloat­ing or gas. I speak from both pro­fes­sional and per­sonal ex­pe­ri­ence.

You also asked about pro­bi­otics. That means we need to talk about bac­te­ria. The world, in­clud­ing our bod­ies, is filled with bac­te­ria. Some are good for us, some bad, some neu­tral. Pro­bi­otics are liv­ing bac­te­ria that we swal­low in or­der to im­prove our health. They come in the form of cap­sules, yo­gurts and even some fruit juices.

Pro­bi­otics are gen­er­ally con­sid­ered safe, but there’s not yet enough ev­i­dence to say that they ef­fec­tively treat IBS. Some of my pa­tients swear by them; oth­ers have not had a pos­i­tive re­sult. No one has had any bad re­ac­tions.

For some peo­ple with IBS, cer­tain foods can trig­ger symp­toms. In par­tic­u­lar, cer­tain sug­ar­like mol­e­cules, known as FODMAPs, can be dif­fi­cult to digest. FODMAPs are found in a wide va­ri­ety of foods in­clud­ing milk, some fruits and veg­eta­bles, wheat, rye, high-fruc­tose corn syrup and ar­ti­fi­cial sweet­en­ers. A lowFODMAP diet may tame IBS symp­toms.

IBS symp­toms are also of­ten trig­gered by emo­tional stress. The fol­low­ing stress-man­age­ment tech­niques may help:

• COG­NI­TIVE BE­HAV­IORAL THER­APY (CBT) can help re­frame neg­a­tive thoughts into more pos­i­tive, pro­duc­tive ways of think­ing. This can help to im­prove symp­toms and qual­ity of life.

• RE­LAX­ATION RE­SPONSE TRAIN­ING AND MED­I­TA­TION are tech­niques that can help re­duce ner­vous sys­tem ac­tiv­ity (the in­testines are partly con­trolled by the ner­vous sys­tem) and re­lax mus­cles.

• YOGA seeks to bring body and mind into bal­ance. It can serve as a form of self-re­lax­ation.

• BIOFEEDBACK is a mind-body tech­nique. Par­tic­i­pants use a biofeedback ma­chine to see and learn to con­trol their body’s re­sponse to pain.

Fiber and pro­bi­otics def­i­nitely help many peo­ple with IBS. For­tu­nately, they are not the only treat­ments. And you’ll no­tice I didn’t even men­tion con­ven­tional medicines, since more “nat­u­ral” ap­proaches of­ten do the trick.

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