This video features ten tips based on expert clinical guidelines published by UpToDate online. These recommendations are presented by Dr. Nicholas Cohen, MD.
Hello i’m dr. nicholas cohen and i’m here to share with you a top 10 list of tips for people with irritable bowel syndrome ibs tip number one no one to suspect when you might have irritable bowel syndrome irritable bowel syndrome is characterized by crampy abdominal pain and you can either have constipation with it or diarrhea and some people alternate between
Constipation and diarrhea so it’s crom crampy abdominal pain that’s associated with either diarrhea constipation or both it is the most common gastrointestinal diagnosis there is and the good thing about it is that though it’s chronic it doesn’t get progressively worse and it has no effect on your lifespan it affects up to 15% of the population it is the number
Two reason why people miss work just behind the common cold so tip number one is when to suspect you might have ibs and knowing how common it is tip number two keep a diary if you suspect that you may have irritable bowel syndrome before you visit your doctor keep a two-week diary in your diary you should write down every time that you have your crampy abdominal
Pain record the time that it occurs in the date also occur write down the time and the date for all of your bowel movements with each of your entries for when you have abdominal pain write down what you did or what you ate or what you drank before the abdominal pain started for instance if you had a cup of coffee write that down if you had milk write that down
If you were feeling under a lot of stress write that down so when you go to your doctor in two weeks you’ll have a food log and maybe together both of you will be able to figure out what makes your abdominal first of all if you have ibs then you’d be able to decide with your doctor what might be the cause so tip number one is identifying when you might have our
Irritable bowel syndrome tip number two is keeping a 2-week food log when you have your abdominal pain as well as a log of any of stressful events or anything you might drink before your abdominal pain tip number three is to see your doctor having a relationship with the doctor while you’re if you have irritable bowel syndrome has been shown to be one of the most
Helpful therapies just having a relationship with your doctor for people with irritable bowel syndrome also it’s important to exclude other causes of constipation abdominal pain or diarrhea this is especially true if you have what are called alarm symptoms if you have any of the following symptoms it’s important to see your doctor right away and they’ll be more
Of an investigation into the cause of your symptoms the alarm symptoms include any rectal bleeding pain that’s getting progressively worse pain that is woken you up at night if you have unexplained weight loss if you have a family member with colorectal cancer or you have a family member with inflammatory bowel disease such as ulcerative colitis or crohn’s when
You meet with your doctor most likely you’ll get some labs drawn to rule out any of these other to rule out other causes of your symptoms these usually include a blood count electrolytes and your doctor may also test you your stool for bacteria and may also test you for celiac disease if some of the lab work suggests a diagnosis other than irritable bowel syndrome
You may also get an x-ray a colonoscopy or sigmoidoscopy where you act where your doctor is able to go in and get a tissue biopsy to explore the possible cause of your condition and make sure when you go see your doctor to bring that foodlog so that you can go over the possible triggers of your symptoms if in fact you conclude together that it is irritable bowel
Center tip number four is once you’ve arrived at with your doctor the diagnosis of irritable bowel syndrome try two weeks each of restricted diets often irritable bowel syndrome is caused by particular or made worse by particular kinds of foods so a two-week period where you don’t eat any of those foods can be very helpful in determining if you have any possible
Food triggers to your symptoms so do the following for two weeks go without caffeine and see how your irritable see how you’re cramping abdominal pain goes after those two weeks go with a lactose free diet so especially milk and ice cream exclude it completely from your diet for two weeks and see how your symptoms are next go for two weeks this is if you have get
A lot of gas with a gas with a diet that’s low in foods that cause gas so exclude beans onions celery carrots raisins bananas apricots prunes brussels sprouts wheat germ pretzels and bagels see how excluding all of these gas forming foods affects your symptoms after that do it to wheat gluten free diet gluten-free meaning excluding all wheat from your diet see
How this affects your symptoms and lastly try a low carbohydrate diet specifically it’s called a fo dmap a low fodmap diet fodmap stands for fermentable oligo and die monosaccharides and polyols there has been research into the cause of irritable bowel syndrome being linked to these types of carbohydrates i said yeah i suggest that if you have gotten to this point
Can your in food restrictions and you’re trying this diet that you either google fod ma p to find out what food what are the common foods to avoid or you ask your doctor about a list of foods to avoid there are so many foods it would take too long to list them here so let’s say you’ve tried restricting each of these food groups at different time and you’re still
Having crampy abdominal pain with constipation or diarrhea the next step and actually something you should be doing no matter what is regular exercise remarkably regular exercise has been shown to help people with irritable bowel syndrome in adults this means at least 30 minutes a day every day and walking at a brisk pace is enough if you are overweight or obese
Then you should be walking or doing a exercise at least an hour a day most if not all days of the week so we’ve gone over how to identify irritable bowel keeping a food log to see what might be causing your heard about seeing a doctor trying restricted diets regular exercise the rest of these tips are our medications or supplements tip number six is psyllium which
Is a fiber psyllium is great you might not think it tastes great i eat it every day and i think it tastes great as well as has so many benefits for your health not only does it have fiber which is important for regular intestinal function but it also lowers your cholesterol psyllium powder has many different comes in many different varieties you can just buy it
As powder and add it to cereal and or you can add it to juice or or water it also comes in a lot of prepared foods crackers wafers and such so i recommend a psyllium powder of the equivalent of one teaspoon a day that’s to start off and then increase or decrease the amount you take based on whether it’s helping or your symptoms or not tip number seven is a fountain
Three as needed medication that can help with the symptoms of irritable bowel for cramping i recommend dicyclomine 20 milligrams up to four times a day as needed another good antispasmodic or anti cramping medicine is hyoscyamine this dose is 0.125 to 0.25 milligrams three to four times a day tribe dicyclomine and then try hyoscyamine and see which one works better
For your cramping if you have diarrhea with your irritable bowel syndrome you can try a little pair amide two milligrams every four to six hours as needed up to 12 milligrams in 24 hours tip number 8 try an antidepressant there are two classes of antidepressants that have been shown to help people with irritable bowel syndrome these are tricyclic antidepressants and
Selective serotonin reuptake inhibitors tricyclic antidepressants are better if you have diarrhea associated with your ibs serotonin selective serotonin reuptake inhibitors ssris are preferred if you have constipation associated with your irritable bowel syndrome i recommend the tricyclic nortriptyline because it has lee it’s one of the least side effect causing of
The tricyclics the tricyclics can cause you to be have difficulty sleeping and can lead to confusion can make your mouth dry neurotriptyline is one of the tricyclics with less of these side effects so to start with this is a prescription so you can be talking to your doctor about it but the recommended starting dose is 10 milligrams at bedtime and you can increase
This every week up to a maximum dose of 75 milligrams per day and the dose should be adjusted just to how much relief you’re getting compared to how much side effects so you don’t want to have too much side effects so that limits the amount the dose you’re taking again if you have constipation predominant irritable bowel then a selective serotonin reuptake inhibitor
Can be tried i recommend paroxetine controlled release controlled release has less of the side effects than the immediate release paroxetine and i recommend and it has an paroxetine among the ssris has one of the least problems with your stomach in terms of side effects other ssris can cause you to have upset stomach paroxetine controlled release has one of the
Least is one of the least likely to cause side effects like this i recommend 25 milligrams as a starting dose at bedtime you can increase the dose by 12.5 milligrams about every week to a maximum dose of 62.5 milligrams per day tip number nine a trial of relaxant ref atzmon is a non absorbable antibiotic so it doesn’t actually go into your bloodstream it works
On the bacteria in your colon and it’s especially good if you have irritable bowel syndrome that’s associated with a lot of constipation and bloating it’s possible it’s thought that relax amin given for two weeks at 550 milligrams three times a day can reduce the bacteria in your colon that are causing gas to produce to be produced again this is a prescription
Medication that you should discuss with your doctor and it’s really only recommended if you’ve tried the fodmap restricted diet or the low carbohydrate restricted diet that i discussed earlier and that has failed to help your bloating and constipation so i’ve covered nine tips for irritable bowel syndrome one is identifying area well bowel syndrome two is keeping
A food log to identify what could be making your irritable bowel syndrome worse three is seeing a doctor too make sure that it is irritable bowel syndrome and to exclude other causes tip number four are various trials that you should make of restricting different types of foods in your diet tip number five are is doing regular exercise tip number six is eating
Psyllium fiber tip number seven are the as needed medications hyoscyamine dicyclomine and loperamide tip number eight are trials of antidepressants specifically ssris and tricyclic antidepressants tip number nine is trial of relax amin and tip number ten believe in yourself irritable bowel syndrome is an extremely common condition in this country it does not get
Worse it does not lead to a decreased lifespan there are many effective options including having a good relationship with your doctor that help irritable bowel syndrome and i made this video as a further aid to your condition i hope these tips have been helpful thank you very much for listening and have a great day
Transcribed from video
Irritable Bowel Syndrome – 10 Tips to Feel Better By myfamilydoc