Old Fashioned Remedies Effective Treatment For IBS
Irritable bowel syndrome (IBS) affects as many as one in five people. Are the new medications the answer?
Not necessarily, according to the results of a study conducted for the American College of Gastroenterology was published online November 13, 2008 in the British Medical Journal.
The study found that fiber, antispasmodics and peppermint oil are all effective therapies for irritable bowel syndrome. The study authors feel that these older treatments should be considered first-line treatments for IBS.
The authors are recommending that national guidelines on the management of Irritable bowel syndrome be updated in light of the evidence presented in their study. The study was a meta-analysis of randomized controlled trials conducted for the American College of Gastroenterology, which is working on evidence-based recommendations for Irritable bowel syndrome treatment.
Irritable bowel syndrome is one of the most common disorders seen by physicians. It begins before age 35 in about 50% of cases and occurs more often in women than men, according to the National Digestive Diseases Information Clearinghouse.
Fiber, antispasmodics, and peppermint oil are cheap, effective, and often available over the counter. Newer medications for IBS have been plagued by safety problems and are marketed only under severe restrictions. However, one, Amitiza, or lubiprostone, was approved in April 2008 for the treatment of IBS with constipation for women 18 and older. It had been marketed since 2006 for treating constipation.
This recent study compared each of the three remedies to placebo or no treatment. More than 2,500 adults were enrolled in the trials.
Twelve studies compared fiber with placebo or no treatment. The studies enrolled 591 patients. Interestingly, the new analysis found that insoluble fiber, such as bran, was not beneficial. The soluble fiber, ispaghula husk or psyllium, significantly reduced symptoms.
Antispasmodics were compared with placebo in 22 studies that had a total of 1, 778 patients. The analysis of these studies found hyoscine was the most successful at preventing symptoms of IBS.
Peppermint oil, which has been shown to have antispasmodic properties, emerged as the most effective of the three agents based on four trials involving 392 patients.
Traditionally, people with IBS were advised to increase their daily intake of dietary fiber because of its potentially beneficial effects on intestinal transit time. Only if that failed were various types of smooth muscle relaxants and antispasmodics used.
The researchers caution that an integrated treatment approach, which takes account of physical, psychological and social factors, is needed. Fiber is of use in constipation. Antispasmodics are useful for the short-term relief of pain, bloating, and gas. Peppermint oil is worth trying as an antispasmodic.