Therapy of irritable bowel syndrome
Since the reasons for the development of irritable bowel syndrome are not known, therapy is limited to alleviating the existing symptoms of irritable bowel syndrome.Especially with this clinical picture it is very important to keep in mind that there are many different forms and degrees of severity, which can vary greatly from person to person in terms of symptoms and course. For this reason, there is no standard therapy for irritable bowel syndrome that can be used to help every person affected, but it must be very precisely tailored to the individual. In general, the therapy comprises three different approaches: medication, general measures and psychological support, which can be used individually or in combination if necessary.
Especially in cases of less pronounced symptoms, an appropriate diet is often sufficient as a treatment for irritable bowel syndrome. However, there is no specific treatment by “irritable bowel diet“, one should simply try to eat a balanced and healthy diet in general. First and foremost, this means taking care to drink plenty of fluids and to eat a mixed diet rich in fiber and varied.
Poorly tolerated drinks and foods, such as strong spices, coffee, alcohol, flatulent (beans, cabbage) or fatty foods and especially hot or cold foods should be avoided if possible. In addition, portions should not be too large when eating and should not be eaten too quickly. Under certain circumstances, nutritional advice can also be helpful.
In some cases, food containing cultures of microorganisms (usually bacteria) (so-called probiotics) can also help. However, these are not always effective and if they are, then only if they are taken regularly. Heat also has a soothing effect on the pain of irritable bowel syndrome, so hot-water bottles or spelt pillows can be placed on the stomach to reduce acute symptoms.
Depending on the symptoms of irritable bowel syndrome, i.e. diarrhea, constipation or flatulence, different medications are used. It should be noted, however, that all preparations should not be used over a long period of time and that they should always be taken only after consulting a doctor. In the case of constipation, one can first try to relieve it by a high-fiber diet, exercise and increased fluid intake.
If these measures do not bring success, one should start a medical treatment. Laxatives are for example lactulose, macrogel or linseed. For diarrhea, on the other hand, swelling agents are used, for example pectins or psyllium preparations, and medication that inhibits intestinal movement and thus bowel movement, for example loperamide, is prescribed.
With flatulence, herbal preparations (phytotherapeutics) in the form of various teas (chamomile, caraway, peppermint, fennel, aniseed) and swelling agents are recommended. If abdominal pain or cramps dominate the clinical picture, antispasmodic painkillers (spasmolytics) such as butylscopalamine or mebeverine are used. In addition, painkillers may be indicated for all forms, the dosage of which must be adapted to the intensity of the pain.
There are also drugs that contain active cultures of lactic acid bacteria (cf. also probiotics) and can thus build up the natural intestinal flora, which can also improve the symptoms in some patients with irritable bowel syndrome. If a form of irritable bowel syndrome is present that is triggered or aggravated by psychological factors, it is advisable to improve these circumstances.
For example, everyone can contribute to the treatment of irritable bowel syndrome by doing relaxation exercises (of which there is an infinite number, each of which appeals to everyone to a different degree, such as autogenic training or meditation), maintaining an orderly daily routine, doing sports regularly, etc. Under certain circumstances, targeted psychotherapy can also prove to be very helpful, although it is not used by many patients. Here too, there are various possibilities: Talk therapy, hypnosis, group therapy, psychoanalysis, etc.
Medication for depression (such as tricyclic antidepressants or serotonin uptake inhibitors) is also sometimes useful to mitigate the psychosomatic component (physical impairments caused by psychological factors) of the disease. Especially with such drugs it is very important to consult a doctor and/or psychotherapist on a regular basis. For the treatment of irritable bowel syndrome, a completely new approach to therapy has been available for some time.The stool transplantation is already used for the therapy of chronic inflammatory intestinal diseases and is now also supposed to help to treat irritable bowel syndrome.
A stool transplantation is the transfer of stool or the bacteria contained in stool from a healthy donor into the intestine of a patient. The aim of stool transplantation is to restore the irreparably damaged intestinal flora of the patient and thus to produce or at least promote a physiological, i.e. healthy microbiome. Since the cause of irritable bowel syndrome is still largely unexplained today and the term irritable bowel actually seems to be more of a collective term for various diseases, a great deal of research is still needed on the subject. There are virtually no studies, case collections or experiences worth mentioning regarding the treatment of irritable bowel syndrome by means of a stool transplant.