How to treat (and not to treat) irritable bowel syndrome

No Joking

Sometimes I wonder if FDA officials are obsessive practical jokers.

Just two weeks ago, the agency gave approval to prescribe the constipation drug Amitiza for patients with irritable bowel syndrome with constipation.

But according to the Amitiza website, the most common side effects are nausea, diarrhea, and abdominal pain. Which just happen to be three symptoms of irritable bowel syndrome.

This sort of irony never seems to phase the drug industry or the FDA.

Amitiza also has another side effect. Again from the website: “Within an hour of taking AMITIZA, a sensation of chest tightness and shortness of breath may occur. These symptoms usually go away within three hours.”

Sure! Don’t worry about a thing. Feel like you’re having a heart attack? That’ll probably be gone by lunchtime. But the nausea, diarrhea, and abdominal pain? No telling how long they’re going to last.

What to leave in…what to leave out

If I had IBS, I would look long and hard for a way to treat the condition before resorting to Amitiza or other drugs.

And that’s the first part of my answer to this question, sent from an HSI member named Marilyn: “A good friend of mine has Irritable Bowel Syndrome. Do you have any information or cures for that?”

Unfortunately, there’s probably no cure for Marilyn’s friend. But an important dietary change might help. Avoid fructose.

A few years ago I wrote to you about a study that showed how a fructose-free diet significantly reduced IBS symptoms.

Fructose is poorly absorbed in the digestive tract of a many IBS patients. So fructose passes into the colon where it’s consumed by bacteria. This produces gases that trigger IBS symptoms such as bloating, cramping, and diarrhea.

Avoiding fructose will be challenging for most patients, so they may need the help of a dietitian. Many processed foods are made with high fructose corn syrup. But fructose also occurs naturally in honey and fruit, and even some vegetables. Other foods that may cause problems include alcohol, caffeinated beverages, milk products, and the inferior fats in junk foods.

Many IBS patients respond well to high fiber diets. Smaller meals may also help. And the American Academy of Family Physicians offers this advice that’s pretty surprising from a mainstream organization: avoid laxatives. According to the AAFP, laxatives can weaken intestines, causing your body to become dependent on them.

Finally, acupuncture and yoga have also been shown to improve IBS symptoms for some patients. And (surprise!) these treatments have no side effects like nausea, diarrhea, and abdominal pain.

Source:
“Sucampo and Takeda Win FDA Approval for Irritable Bowel Syndrome Drug” Datamonitor, 10/21/09, datamonitor.com