Irritable bowel syndrome 101 part 6

Psychotherapy

Many individuals with IBS tend to be under stress and undue tension. This often aggravates the condition and symptoms. To relieve tension, a variety of psychotherapy techniques have been utilized to reduce stress; this includes cognitive behavior therapy, hypnosis, stress management, yoga, acupuncture and relaxation. Psychotherapy does benefit some patients. The problem with these techniques is that it requires a long-term commitment and results are not immediate. In addition, these treatments are quite expensive and not usually covered by medical insurance plans. When treatments are stopped, relapses are common. Overall, about 10-20 percent of patients with mild IBS show benefit with psychotherapy.

Serotonin Receptor antagonists

A new class of drugs like Alosetron (lotronex) has been approved for use in decreasing symptoms of IBS. Lotronex has been shown to increase colonic compliance, and decreases gastrocolonic reflexes. So far, a few studies indicate that this drug can lead to modest benefit over a sugar pill, reduce bloating, and pain. When the drug was first released, it was linked to a few deaths. However, it is now again available with strict prescribing regulations. Alosetron is currently indicated only for women with severe diarrhea-predominant symptoms in whom conventional treatment has failed. Constipation is a common complaint with use of this drug.

Another drug released for IBS is Tegaserod (zelnorm). It has been found to be of mild benefit in individuals with constipation-predominant IBS. Tegaserod is approved for up to 12 weeks for treatment of constipation-predominant IBS in women. At present there is still some concern regarding long-term safety of the drug. Individuals with generalized symptoms of IBS do improve but the benefits are mild. More studies are needed before the drug can be used in all patients with IBS.

Probiotics & Antibiotics

The role of antibiotics in IBS is not common. Antibiotics are only used when an infection is suspected. Prolonged use of antibiotics can lead to severe diarrhea due to overgrowth of bowel bacteria.

The health food industry is heavily marketing Probiotics for treatment of IBS. Probiotics consist of mixtures of live organisms that are presumed to restore normal bowel flora. To date, most reports of efficiency of Probiotics are made by vendors of these products. Scientific studies are lacking. In addition, not everyone sees benefits from Probiotics