أسئلة وأجوبة مايو كلينك: متلازمة القولون المتهيج وتعديلات نمط الحياة

Dear Sirs at Mayo Clinic: I was diagnosed with a mild case of IBS, and spoke with my doctor about managing my symptoms without medication. I am more interested in trying to focus on diet to control my condition. Are there certain things I should focus on, or will medications be the only way for me to manage my symptoms?

Ans: Although medications can be used to treat irritable bowel syndrome , not everyone with this disorder needs medications. For some people — especially those with mild symptoms — lifestyle modifications, such as adjusting diet, managing stress and getting regular exercise, are enough to control symptoms. For moderate to severe symptoms, a combination of lifestyle changes and medications may be necessary to control IBS.

Irritable bowel syndrome sometimes affects the large and small intestine. The walls of the intestine are lined with layers of muscle that contract and relax in a coordinated rhythm to move food through the digestive tract. When you have IBS, these contractions may be stronger or more noticeable than usual. This can lead to abdominal cramps and pain as food, gas or stool passes through the intestines. Irritable bowel syndrome is also associated with bowel disorders, such as diarrhea or constipation . Other symptoms may include gas and bloating.

In those diagnosed with irritable bowel syndrome, it is important to realize that some abdominal problems are not related to the disorder and could indicate another underlying problem. In particular, the following symptoms require immediate medical attention: blood in the stool, rapid or unexplained weight loss, severe or severe abdominal pain, unexplained vomiting, severe pain with or without difficulty swallowing, or Abdominal lump.

Irritable bowel syndrome is a chronic condition, and its symptoms tend to come and go over time. There is no cure, but symptoms can often be relieved through diet, lifestyle, and stress management.

More than 60% of people with IBS say their symptoms are related to food in some way. However, because symptoms vary widely from person to person, it is difficult to provide specific dietary advice that works for everyone with this disorder.

In general, eating high-fiber foods and drinking plenty of fluids is beneficial for many people with IBS. Avoid foods and drinks that contribute to gas and bloating, including: carbonated and alcoholic drinks; caffeine; raw fruit; Vegetables such as cabbage, broccoli and cauliflower. Reducing or eliminating gluten may relieve the diarrhea associated with IBS.

Research has shown that some carbohydrates, known as fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), can lead to abdominal pain, bloating and gas in people with IBS. It is found in some fruits and vegetables; wheat; corn; legumes; foods that contain lactose, such as: milk, cheese and yogurt; and industrial sweeteners.

Following a “low-FODMAP” diet can relieve symptoms of IBS. But because many foods contain these compounds, it can be difficult for patients to create such a diet on their own. Finding a dietitian familiar with IBS can help. A dietitian can review a person’s symptoms and nutritional needs, discuss recommended dietary changes, and develop an individualized eating plan to relieve symptoms.

Stress also affects irritable bowel syndrome, where episodes of high stress are associated with increased symptoms. Using stress-reducing techniques and participating in activities that relieve stress, such as yoga and meditation, may reduce stress-related disorders. Follow-up with a therapist or counselor experienced in stress management, mental focus and behavior modification may also help people with IBS better manage stress and relieve symptoms.

It is recommended that people with IBS get regular exercise. Daily physical activities relieve stress, stimulate the natural contractions of the intestines, and promote overall health.

If lifestyle changes alone aren’t enough to prevent irritable bowel syndrome from disrupting daily life, talk to your health care professional about medication options. A variety of prescription and over-the-counter medications are available to treat irritable bowel syndrome. —  Dr. Robert Crisley , Gastroenterology, Mayo Clinic, Rochester, Minnesota

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