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Treating irritable bowel syndrome (IBS) and diarrhoea

Irritable bowel syndrome (IBS) is one of the most common digestive disorders seen by GPs. The cause of IBS is unknown, but it can develop during a bout of gastroenteritis (‘tummy upset’) and then continues long after the original infection has gone. Diet doesn’t cause IBS, but symptoms may be controlled to some extent with dietary changes. IBS does not increase your risk of other more serious conditions such as bowel cancer.

This article focuses on treatment of IBS with diarrhoea - runny stools or poo, which may occur several times a day and be hard to control.

There are many approaches to dealing with IBS that depend on your symptoms.

Treatment options include:

  • Changes to diet
  • Medication
  • Mind/body therapies

Talk to your doctor about treatment options and before trying any remedies yourself.

Some over-the-counter medicines and supplements have health risks if taken for a long time.

IBS and diet

A few changes in your diet may help ease IBS with diarrhoea. Avoid those foods that you identify as symptom-triggers. Common foods that may cause diarrhoea include:

  • Wholemeal bread and wholegrain cereals, nuts
  • Bran and fibres eg isphagula husk, wheat bran
  • Magnesium and vitamin C high dose supplements
  • Caffeine from coffee, cola drinks, fast acting pain medicines and tea
  • Lactose (milk sugar) and fructose (fruit sugar). A trial of lactose free milk and fruit juice avoidance will help identify if these natural sugars are a problem, especially if bloating is present along with diarrhoea.
  • Sugar-free gums and sweets containing sorbitol or xylitol sweeteners which can cause diarrhoea in relatively small amounts.

It might also help if you keep a food and symptom diary, noting your diet and daily symptom severity. Don't try any diets to exclude certain foods without medical or registered dietitian supervision.

The NHS also suggests having regular meal times, not skipping meals, and drinking plenty of water.

Medication for IBS

Medication for IBS targets specific symptoms. For example:

  • Antispasmodics - such as mebeverine and peppermint oil, can help relieve abdominal pain and cramping by relaxing the intestinal muscles. Peppermint may cause gastric reflux and heartburn, so supplements may be supplied as tablets that dissolve once they have travelled through the stomach.
  • Antimotility - loperamide can help reduce diarrhoea.
  • Antidepressants may be prescribed for abdominal pain and cramping.
  • Probiotics - Although some people report that probiotics help relieve their IBS symptoms if they take them regularly, the NHS says there is no scientific evidence to prove that probiotics work and have beneficial health effects.
  • Guar gum at amounts of at least 5g per day has been shown to help both constipation and diarrhoea-predominant IBS.
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