Allopathic treatment for Irritable bowel syndrome

Definition
Irritable bowel syndrome (IBS) is a common intestinal condition characterized by abdominal pain and cramps; changes in bowel movements (diarrhea, constipation, or both); gassiness; bloating; nausea; and other symptoms. There is no recognized cure for IBS. Much about the condition remains unknown or poorly understood; however, dietary changes, drugs, and psychological treatment are often able to eliminate or substantially reduce its symptoms.

Description
IBS is the name people use today for a condition that was once called colitis, spastic colon, nervous colon, spastic bowel, and functional bowel disorder. Some of these names reflected the now-outdated belief that IBS is a purely psychological disorder and a product of the patient's imagination. Although modern medicine recognizes that stress can trigger IBS attacks, medical specialists agree that IBS is a genuine physical disorder or group of disorders with specific identifiable characteristics.

No one knows for sure how many Americans suffer from IBS. Surveys indicate a range of 10-20%, with perhaps as many as 30% of Americans experiencing IBS at some point in their lives. IBS normally makes its first appearance during young adulthood, and in half of all cases, symptoms begin before age 35. Women with IBS outnumber men by two to one, for reasons not yet understood. IBS is responsible for more time lost from work and school than any medical problem other than the common cold. It accounts for a substantial proportion of the patients seen by gastroenterologists, who are specialists in diseases of the digestive system. Yet only half—possibly as few as 15%—of IBS sufferers ever consult a doctor.

Causes & symptoms
The symptoms of IBS tend to rise and fall in intensity rather than grow steadily worse over time. They always include intestinal (abdominal) pain that may be relieved by defecation; diarrhea or constipation; or diarrhea alternating with constipation. Other symptoms, which vary from person to person, include cramps, gassiness, bloating, nausea, a powerful and uncontrollable urge to defecate (urgency), passage of a sticky fluid (mucus) during bowel movements, or the feeling after finishing a bowel movement that the bowels are still not completely empty. The accepted diagnostic criteria, known as the Rome criteria, require at least three months of continuous or recurrent symptoms before IBS is diagnosed. According to Christine B. Dalton and Douglas A. Drossman in the American Family Physician, an estimated 70% of IBS cases can be described as "mild"; 25% as "moderate"; and 5% as "severe." In mild cases the symptoms are slight. As a general rule, they are not present all the time and do not interfere with work and other normal activities. Moderate IBS disrupts normal activities and may cause some psychological problems. People with severe IBS may constantly fear the unpredictable need for a bathroom. They often find living a normal life impossible and experience crippling psychological problems as a result. For some, the physical pain is constant and intense.

Allopathic treatment
Dietary changes, sometimes supplemented by drugs or psychotherapy, are considered the key to successful treatment. A drug called alosetron (Lotronex) was approved by the Food and Drug Administration (FDA) in 2002 for limited marketing for treating women with diar-rhea-prominent IBS after some controversy in 2000 because of serious side effects from the drug. Its use should be limited to only those patients suffering from severe, chronic diarrhea-predominant IBS who have failed to respond to conventional therapy.

An individualized diet, low in saturated fats and foods that trigger the patient's reaction, can reduce symptoms for many IBS sufferers. Caffeine sources, sugar, and alcohol usually worsen symptoms. Bran or 15-25 grams a day of an over-the-counter psyllium laxative may also help both constipation and diarrhea. The patient can have milk or milk products if lactose intolerance is not a problem. Establishing set times for meals and bathroom visits may help people with irregular bowel habits, especially for constipated patients.

Although a high-fiber diet remains the standard treatment for constipated patients, such laxatives as lactulose or sorbitol may be prescribed. Loperamide and cholestyramine are suggested for diarrhea. Abdominal pain after meals can be reduced by taking antispasmodic drugs such as hyoscyamine or dicyclomine before eating.

Psychological counseling or behavioral therapy may be useful for some patients to reduce anxiety and to learn to cope with the pain and other symptoms of IBS. Relaxation therapy, hypnosis, biofeedback, and cognitive-behavioral therapy are examples of behavioral therapy.