Guidelines for early diagnosis of digestive disorders adapted from the British Society of Gastroenterology & Digestive Disorders Foundation.

Everyone experiences occasional digestive upsets such as indigestion, flatulence or a disturbance of bowel habit. These can be regarded as normal andare often caused by diet, lifestyle or a change in routine. 

If symptoms of this sort persist or worsen, or if you develop new digestive symptoms which you have not previously experienced, these may be caused by a digestive disorder which needs treatment. 

You should see your doctor if you experience the following symptoms, particularly if they are unexpected or persistent: 

• Abdominal pain before or after meals. 
• Persistent feeling of fullness, bloating or flatulence. 
• Nausea or vomiting. 
• Heartburn, regurgitation or water brash. 
• Pain or difficulty in swallowing. 
• Loss of appetite. 
• Continuing unexplained weight loss. 
• Indigestion developing for the first time in mid or later life. 
• Persisting diarrhea, constipation or any alteration in bowel habit. 
• Change in your stools (bowel motions), especially if they become black, dark red, pale or contain mucus (slime). 
• Bleeding when you pass a stool. 
• Pain when you pass a stool. 
• Feeling that your bowels are emptying incompletely. 
• Generally feeling tired, lethargic or unwell in association with any abdominal symptoms.

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The above guidelines are adapted from the leaflet produced by www.digestivedisorders.org.uk in association with the British Society of Gastroenterology - The Professional Society for Gastroenterologists.

Conventional Approach

Because there is no cure for IBS, allopathic medicine works to relieve its symptoms. Self-treatment measures include adding fiber to the diet (from food sources such as bran and vegetables) and reducing stress (by exercising and adopting regular sleep habits). Fiber can also be added in the form of bulking agents, including methylcellulose and psyllium. Taken with fluids, they can relieve diarrhea as well as constipation. If anxiety or stress are thought to play a role in the patient’s IBS, then psychotherapy can be effective.

Medications can be effective for some patients. They may include:

• Anticholinergic drugs, such as propantheline, block the responses of nerves in the colon. Potential side effects are dry mouth, blurred vision, and difficult urination.
• Narcotics, including diphenoxylate and loperamide, can stop diarrhea by slowing the movement of stool through the intestine. They can lead to constipation and are potentially addictive.
• Antidepressants, such as amitriptyline, may be effective, whether the patient is depressed or not. They can, however, cause dizziness, hot flashes, and other side effects.
• Antianxiety drugs, such as chlordiazepoxide, fight off anxiety by decreasing nerve activity in the brain. If used regularly, they can become addictive.
• Barbiturates, including phenobarbital, bring feelings of calmness. Side effects can range from drowsiness to excitement.

Some conventional doctors have also recognized the benefits of the alternative approach of biofeedback training.

Alternative Approaches

Several alternative therapies can offer relief from the symptoms of IBS or even prevent them. These treatments are usually combined with a high-fiber diet, exercise, and stress-reduction techniques.

Biofeedback Training

Biofeedback training has been shown to be very effective in the treatment of IBS. One way that biofeedback can help is by teaching people with IBS to manage stress in their lives, thereby lessening the chances of future attacks. Especially when combined with other relaxation techniques, this approach to prevention is effective enough to attract the attention of many conventional physicians.

To a lesser extent, people may use biofeedback training to gain control over some actions of the colon. The treatment uses monitors that "feed back" certain biological levels. Armed with this information, patients can learn to alter involuntary functions of the body.

Thermal biofeedback is often used to teach relaxation to people with IBS. Here’s how it works:

• The biofeedback trainer tapes sensors to the patient, often on the finger, to measure skin temperature. Shown on the monitor, the temperature is used to gauge the level of blood flow.
• Next, the trainer leads the patient through various visualization and breathing exercises—all designed to bring a state of relaxation to the patient.
• The monitor shows whether there is any progress—a corresponding rise in skin temperature. The patient and trainer can then use the information to guide or intensify visualization efforts.

Several studies have shown positive results for people with IBS when biofeedback is combined with instruction in positive thinking or assertiveness and education on the link between stress and the bowels.

Biofeedback trainers will usually instruct their patients in progressive muscle relaxation, which can be done at Home Page to reinforce the training sessions. Here is an example of progressive muscle relaxation:

• Wearing loose clothing, lie down on a firm but not hard surface.
• Close your eyes and imagine tightening the muscles in your feet.
• Then release these muscles.
• Next, direct your attention to your calves, tensing and then easing these muscles in the same fashion.
• Continue up the body, including your arms, until you end with your scalp.

  Nutritional Therapy

Nutritional therapists hold that altering the diet may prevent the symptoms of IBS. One well-established strategy is to increase your intake of fiber to help regulate the bowels. However, this should be done with caution. Excessive fiber, particularly insoluble fiber, can exacerbate IBS symptoms in a few people.

Several foods or specific ingredients seem to trigger IBS in some patients. In fact, food allergies and sensitivities may play a role in the condition. The common culprits include

• dietary fats
• corn
• wheat
• monosodium glutamate
• fructose
• caffeine
• dairy products
• tomatoes

Nutrient deficiencies can be a problem for some people with IBS because intestinal abnormalities make absorption of certain nutrients difficult. In these cases, supplementation may be helpful.

The best way to tell if a certain food is to blame for your bouts with IBS is to keep a food and symptom diary. Record the following in your diary:

• What you eat and when
• What symptoms you experience and when they occur
• How you’re feeling each day (relaxed, stressed, excited, and so on)

After about a month, any correlations should be apparent. You can also bring your diary to your physician or practitioner; it may help them identify problems.

Herbal Medicine

Herbs can be effective in easing disturbances in the digestive system and in reducing anxiety. Peppermint oil, which contains menthol, can reduce gas and abdominal pain and relax the intestinal muscles.

In a British study, tablets of peppermint oil worked better than a placebo in reducing the symptoms of IBS. The tablets had a special coating (called enteric) that allowed them to disintegrate in the small intestines, not the stomach. This coating also lessens the possibility of heartburn.

Other useful herbs include

• bayberry
• chamomile
• ginger
• marshmallow
• meadowsweet
• valerian

Here’s a sample prescription for peppermint oil: Take two enteric-coated capsules (each containing 0.2 mL of oil) three times a day. Lower the dose as symptoms subside. Using enteric-coated capsules is very important to ensure that the oil is released at the proper time.

Other Therapies

HOMEOPATHY—Several remedies can be very helpful but an appropriate prescription requires an expert evaluation.

HYPNOTHERAPY—Certain techniques can teach people with IBS to relax and to imagine the easing of the bowel muscles. Several studies have shown that hypnotherapy reduces IBS symptoms in up to 85 percent of patients tested.

YOGA—Several aspects of yoga can be very effective relaxation tools.

This medication section is adapted from www.knowledgecenters.versaware.com/notoc .

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