Irritable bowel syndrome self-care

by | Gastrointestinal Health, Pharmacy Care

General Information

Irritable bowel syndrome (IBS) is a common problem. It involves abdominal pain with changes in bowel habits. Around 20% of people are likely to suffer from IBS at some point during their lives.

IBS is more common in women than in men and occurs more often in younger people. IBS is usually ongoing, and there are some times when symptoms are worse than other times. Having IBS does not mean you are more likely to develop colon cancer later in life.

A diagnosis of IBS may be made by your doctor after other causes of your symptoms have been ruled out.

Symptoms of IBS

Some people with IBS mainly have constipation, others have diarrhoea. Many people with IBS alternate between periods of constipation and diarrhoea. Symptoms include:

  • cramps and bloating in your lower abdomen, which usually get better after having a bowel motion or passing wind
  • pain that can be a sharp or dull feeling
  • constipation: feeling that you have not managed to empty your bowels completely, having bowel motions less often, straining to pass a motion or passing small, hard stools
  • diarrhoea: having bowel motions too often and passing loose stools
  • flatulence, or wind, and/or rumbling noises from your abdomen
  • needing to rush to the toilet
  • headaches
  • mucus in your stools

IBS triggers

The cause of IBS is not known, but certain things can trigger its symptoms, including:

  • stress
  • depressed mood
  • food poisoning
  • certain food and drinks
  • some medication
  • some people find avoiding alcohol, caffeine and nicotine can reduce their IBS symptoms
  • some women suffer from symptoms of IBS just before, or during, their period
  • lactose intolerance may be a cause and needs to be diagnosed by a doctor before permanent changes to diet are made

See Your Pharmacist or Medical Professional

  • if you have an ongoing change in bowel habit, especially if you are aged over 40
  • if you have blood in your stools
  • if you have unexplained weight loss
  • if you also have a fever or vomiting that recurs often
  • if you have severe constipation, diarrhoea or abdominal pain
  • if you are being woken at night by your symptoms
  • if you have recently travelled overseas, particularly to developing countries
  • if there has been a change in your usual symptoms
  • if there is family history of colon cancer
  • if a child is presenting with symptoms of IBS

Treatment Tips

  • keep a diary of events surrounding each IBS attack to help identify triggers
  • reduce stress; relaxation techniques or counselling can be helpful
  • exercise regularly; being active helps digestion
  • eat a well balanced diet, including plenty of fresh fruit and vegetables, and drink lots of water
  • high-fibre foods, such as cereals and bran, help some people, but can make bloating symptoms worse in others
  • increase fibre gradually; avoid excessive amounts.
  • avoid smoking and speak to your healthcare professional about options to help you quit if you are a smoker

Treatment Options

  • if diet and lifestyle changes do not help on their own, medicines can be used to manage symptoms of IBS

Diarrhoea in IBS

Antidiarrhoeal medicines

e.g. loperamide (Gastro-Stop, Harmonise, Imodium Capsules, Caplets and Melts)

  • anti-diarrhoeal medications work by slowing down bowel movements, which allows time for more water to be absorbed back out of the stools, making them less loose
  • they also help reduce cramping, abdominal pain and the frequency of bowel motions.
  • they are not to be used in children

e.g. atropine and diphenoxylate (Lomotil)

  • atropine and diphenoxylate may cause drowsiness

Treatments that may help either diarrhoea or constipation in IBS

Bulk-forming laxatives

e.g. psyllium (Metamucil range, Mucilax), psyllium + maize starch (Nucolox), sterculia (Normacol Plus, Normafibe), ispaghula husk (Fybogel)

Food (fibre) supplements

e.g. gluten-free wheat dextrin (Benefiber)

  • bulk-forming laxatives or fibre supplements may be used by some people with IBS to normalise stool consistency when stools are particularly loose
  • if bulk-forming laxatives are taken without the usual amount of water, they bulk up the stool making it easier to pass
  • alternatively, bulk-forming laxatives may also be used for constipation in IBS; when this is the case, then they need to be taken with plenty of water
  • Benefiber is a fine powder with minimum taste; it can be sprinkled on foods and in cooking without pre-mixing to increase fibre content of the diet

Constipation in IBS

Osmotic laxatives, iso-osmotic laxatives and stool-softeners

e.g. osmotic laxatives: osmotic salts (Microlax enema, Fleet Ready-to-Use Enema, Epsom salts), sorbitol (Sorbilax), lactulose (Duphalac, Genlac), glycerol (Glycerol Suppositories BP)

e.g. iso-osmotic laxatives: macrogol 3350 with electrolytes (Movicol, Movicol-Half),

e.g. stool softeners: poloxamer (Coloxyl Drops), liquid paraffin (Agarol, Parachoc)

e.g. osmotic laxative: sodium picosulphate (Picolax)

  • osmotic laxatives, such as lactulose, work by pulling more water into your stools, making them less hard
  • they do not have an immediate effect and may need to be used for a few days before they begin to work
  • lactulose can be mixed with water, fruit juice, lemonade or milk to make it more palatable. It contains some lactose so people with lactose intolerance or diabetes should check with their pharmacist before taking
  • iso-osmotic laxatives, such as macrogol 3350, deliver extra water to your bowel and help soften stools; they usually take one or two days to work
  • stool softeners, such as docusate, help water to get into stools, making them softer
  • a Microlax enema can be used if your constipation is severe, and should work within 30 minutes.
  • glycerol suppositories act within 15 to 30 minutes
  • if long-term use is required, check with your pharmacist, as some osmotic laxatives can lead to an imbalance in your body salts

Stimulant laxatives

e.g. senna (Senokot), bisacodyl (Dulcolax tablets, Dulcolax suppositories, Bisalax tablets and enemas), sodium picosulphate (Dulcolax SP Drops)

  • stimulant laxatives directly stimulate your bowel to cause movement
  • these should be taken at night to have an effect the next day
  • they should be used for a short period of time only unless advised by your doctor
  • they can sometimes cause abdominal cramps
  • tablets work in about eight hours; suppositories work more quickly
  • they are not recommended in young children or during pregnancy

Combination laxatives

e.g. frangula and sterculia (Normacol Plus)

  • this product contains a bulk-forming laxative and a stimulant laxative

e.g. docusate and senna (Coloxyl with Senna)

  • this product contains a stool-softener and a stimulant laxative

Abdominal pain in IBS

Products to relieve cramping, bloating and flatulence

e.g. peppermint oil (Mintec)

e.g. hyoscine butylbromide (Buscopan, Setacol)

  • peppermint oil can help with cramping, bloating and flatulence
  • it is important to swallow peppermint oil capsules whole to avoid mouth and throat irritation
  • hyoscine may help with cramping
  • other medications, such as mebeverine (Colofac), are Prescription Only medicines, only available on prescription from your doctor

Other products

Dietary supplements

probiotics, e.g. Saccharomyces boulardii, Lactobacillus rhamnosus and Bifidobacterium spp.

  • may help to regulate the digestive system, encouraging more uniform stools

More Information

Availability of medicines

  • GENERAL SALE available through pharmacies and possibly other retail outlets.
  • PHARMACY ONLY available for sale through pharmacies only.
  • PHARMACIST ONLY may only be sold by a pharmacist.
  • PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.

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