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Nevicute
Irritable Bowel Syndrome is a diagnosis of exclusion. It is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. In some cases, the symptoms are relieved by bowel movements. Diarrhea or constipation may predominate, or they may alternate (classified as IBS-D, IBS-C or IBS-A, respectively). IBS may begin after an infection (post-infectious, IBS-PI), a stressful life event, or onset of maturity without any other medical indicators.
Although there is no cure for IBS, there are treatments that attempt to relieve symptoms, including dietary adjustments, medication and psychological interventions. Patient education and a good doctor-patient relationship are also important
An Australian study recently published in the Journal of the American Medical Association lends strong scientific support to the traditional use of Chinese herbs in the treatment of irritable bowel syndrome (IBS). The authors believe theirs is the first clinical study to rigorously document the effectiveness of Chinese herbal medicine in the treatment of IBS - and the first to incorporate traditional Chinese diagnosis and treatment methods for IBS into a strictly controlled, conventional study model [Bensoussan et al., 1998].
The randomized, placebo-controlled, double-blind study involved 116 people with active IBS recruited from hospitals and private gastroenterology practices in Sydney, Australia. Patients were diagnosed first by gastroenterologists using standard western diagnostic methods, and then by Chinese herbalists according to the principles of Chinese medicine.
Forty-three subjects were randomized to receive a standard Chinese herbal formula "considered to regulate and strengthen bowel function," 38 took individualized herbal formulas, and 35 received a placebo deemed to be indistinguishable from the herbal treatments. Treatments were administered by capsule. Individualized treatments were custom-designed by the Chinese herbalists, who also supervised treatment during the course of the trial. Each subject worked with only one herbalist for the duration of the study. Results were evaluated by gastroenterologists after eight weeks and again at the end of the 16-week treatment period.
Both the standard herbal formula and the individualized treatments were significantly more effective than placebo in relieving IBS symptoms. Not only did Chinese herbal therapy prove superior to placebo, the researchers concluded that treatment benefits were more sustained in patients who took individualized formulas than in those who took the standard formula. Patients receiving the herbal formulas had significantly better scores in four out of five key outcome measures. Those taking the standard formula improved by 44 percent (according to patient assessments) and 59 percent (according to physician assessments) and those receiving individualized treatments improved by 42 percent and 40 percent, compared to 22 percent and 19 percent improvements in subjects taking placebo.The standard formula used in the trial, consisting of 20 Chinese herbs, was not identified by name in the paper, nor were the individualized formulas described. The herbs included in the highest proportions in the standard formula were yin chen at 13 percent (Artemisia capillaris Thunb., Asteraceae), bai zhu at 9 percent (Atractylodes macrocephala Koidz., Asteraceae), dang shen at 7 percent (Codonopsis pilosula [Franch.] Nannfeldt., Campanulaceae), yi yi ren (Job's tears) at 7 percent (Coix lacryma-jobi L., Poaceae), and wu wei zi (schizandra) at 7 percent (Schisandra chinensis [Turcz.] Baill., Schisandraceae).
Two patients withdrew from the study because of adverse effects related to the herbal treatment (gastrointestinal discomfort and headache). No other major adverse effects were reported.
As many as 10 to 20 percent of Americans and Australians may be afflicted with IBS, a chronic gastrointestinal disorder marked by abdominal pain, bloating, and disturbances in bowel function alternating from constipation to diarrhea. According to the authors of the study, no single medical treatment provides reliable relief or resolution of the condition. According to physician assessments in this study, 78 percent of patients taking the standard Chinese herbal formula and 50 percent of those receiving individualized formulas improved during treatment, compared with 30 percent of those taking placebo.
For additional we can using treatments have been found to be better than placebo, including fiber, antispasmodics, and peppermint oil. Some of treatments :
Diet
Some people with IBS are likely to have food intolerances. In 2007 the evidence base was not strong enough to recommend restrictive diets.
Many different dietary modifications have been attempted to improve the symptoms of IBS. Some are effective in certain sub-populations. As lactose intolerance and IBS have such similar symptoms a trial of a lactose free diet is often recommended. A diet restricting fructose and fructan intake has been shown to successfully treat the symptoms in a dose-dependant manner in patients with fructose malabsorption and IBS.
While many IBS patients believe they have some form of dietary intolerance, tests attempting to predict food sensitivity in IBS have been disappointing. One study reported that an IgG antibody test was effective in determining food sensitivity in IBS patients, with patients on the elimination diet experiencing 10% greater symptom reduction than those on a sham diet. More data is necessary before IgG testing can be recommended.
There is no evidence that digestion of food or absorption of nutrients is problematic for those with IBS at rates different from those without IBS. However, the very act of eating or drinking can provoke an overreaction of the gastrocolic response in some patients with IBS due to their heightened visceral sensitivity, and this may lead to abdominal pain, diarrhea, and/or constipation.
Fiber might be beneficial in those who have a predominance of constipation. In patients who have constipation predominant irritable bowel, soluble fiber at doses of 20 grams per day can reduce overall symptoms but will not reduce pain. The research supporting dietary fiber contains conflicting, small studies that are complicated by the heterogeneity of types of fiber and doses used.
One meta-analysis found that only soluble fiber improved global symptoms of irritable bowel, but neither type of fiber reduced pain. However, an updated meta-analysis by the same authors found that soluble fiber reduced symptoms. Positive studies have used 10–30 grams per day of psyllium seed. One study specifically examined the effect of dose and found that 20 grams of ispaghula husk was better than 10 grams and equivalent to 30 grams per day. An uncontrolled study noted increased symptoms with insoluble fibers. It is unclear if these symptoms are truly increased compared with a control group. If the symptoms are increased, it is unclear if these patients were diarrhea predominant (which can be exacerbated by insoluble fiber), or if the increase is temporary before benefit occurs.
Drugs affecting serotonin (5-HT) in the intestines can help reduce symptoms. Serotonin stimulates the gut motility and so agonists can help constipation-predominate irritable bowel, while antagonists can help diarrhea-predominant irritable bowel. (Magusba.blogspot.com)
An Australian study recently published in the Journal of the American Medical Association lends strong scientific support to the traditional use of Chinese herbs in the treatment of irritable bowel syndrome (IBS). The authors believe theirs is the first clinical study to rigorously document the effectiveness of Chinese herbal medicine in the treatment of IBS - and the first to incorporate traditional Chinese diagnosis and treatment methods for IBS into a strictly controlled, conventional study model [Bensoussan et al., 1998].
The randomized, placebo-controlled, double-blind study involved 116 people with active IBS recruited from hospitals and private gastroenterology practices in Sydney, Australia. Patients were diagnosed first by gastroenterologists using standard western diagnostic methods, and then by Chinese herbalists according to the principles of Chinese medicine.
Forty-three subjects were randomized to receive a standard Chinese herbal formula "considered to regulate and strengthen bowel function," 38 took individualized herbal formulas, and 35 received a placebo deemed to be indistinguishable from the herbal treatments. Treatments were administered by capsule. Individualized treatments were custom-designed by the Chinese herbalists, who also supervised treatment during the course of the trial. Each subject worked with only one herbalist for the duration of the study. Results were evaluated by gastroenterologists after eight weeks and again at the end of the 16-week treatment period.
Both the standard herbal formula and the individualized treatments were significantly more effective than placebo in relieving IBS symptoms. Not only did Chinese herbal therapy prove superior to placebo, the researchers concluded that treatment benefits were more sustained in patients who took individualized formulas than in those who took the standard formula. Patients receiving the herbal formulas had significantly better scores in four out of five key outcome measures. Those taking the standard formula improved by 44 percent (according to patient assessments) and 59 percent (according to physician assessments) and those receiving individualized treatments improved by 42 percent and 40 percent, compared to 22 percent and 19 percent improvements in subjects taking placebo.The standard formula used in the trial, consisting of 20 Chinese herbs, was not identified by name in the paper, nor were the individualized formulas described. The herbs included in the highest proportions in the standard formula were yin chen at 13 percent (Artemisia capillaris Thunb., Asteraceae), bai zhu at 9 percent (Atractylodes macrocephala Koidz., Asteraceae), dang shen at 7 percent (Codonopsis pilosula [Franch.] Nannfeldt., Campanulaceae), yi yi ren (Job's tears) at 7 percent (Coix lacryma-jobi L., Poaceae), and wu wei zi (schizandra) at 7 percent (Schisandra chinensis [Turcz.] Baill., Schisandraceae).
Two patients withdrew from the study because of adverse effects related to the herbal treatment (gastrointestinal discomfort and headache). No other major adverse effects were reported.
As many as 10 to 20 percent of Americans and Australians may be afflicted with IBS, a chronic gastrointestinal disorder marked by abdominal pain, bloating, and disturbances in bowel function alternating from constipation to diarrhea. According to the authors of the study, no single medical treatment provides reliable relief or resolution of the condition. According to physician assessments in this study, 78 percent of patients taking the standard Chinese herbal formula and 50 percent of those receiving individualized formulas improved during treatment, compared with 30 percent of those taking placebo.
For additional we can using treatments have been found to be better than placebo, including fiber, antispasmodics, and peppermint oil. Some of treatments :
Diet
Some people with IBS are likely to have food intolerances. In 2007 the evidence base was not strong enough to recommend restrictive diets.
Many different dietary modifications have been attempted to improve the symptoms of IBS. Some are effective in certain sub-populations. As lactose intolerance and IBS have such similar symptoms a trial of a lactose free diet is often recommended. A diet restricting fructose and fructan intake has been shown to successfully treat the symptoms in a dose-dependant manner in patients with fructose malabsorption and IBS.
While many IBS patients believe they have some form of dietary intolerance, tests attempting to predict food sensitivity in IBS have been disappointing. One study reported that an IgG antibody test was effective in determining food sensitivity in IBS patients, with patients on the elimination diet experiencing 10% greater symptom reduction than those on a sham diet. More data is necessary before IgG testing can be recommended.
There is no evidence that digestion of food or absorption of nutrients is problematic for those with IBS at rates different from those without IBS. However, the very act of eating or drinking can provoke an overreaction of the gastrocolic response in some patients with IBS due to their heightened visceral sensitivity, and this may lead to abdominal pain, diarrhea, and/or constipation.
- Fiber
Fiber might be beneficial in those who have a predominance of constipation. In patients who have constipation predominant irritable bowel, soluble fiber at doses of 20 grams per day can reduce overall symptoms but will not reduce pain. The research supporting dietary fiber contains conflicting, small studies that are complicated by the heterogeneity of types of fiber and doses used.
One meta-analysis found that only soluble fiber improved global symptoms of irritable bowel, but neither type of fiber reduced pain. However, an updated meta-analysis by the same authors found that soluble fiber reduced symptoms. Positive studies have used 10–30 grams per day of psyllium seed. One study specifically examined the effect of dose and found that 20 grams of ispaghula husk was better than 10 grams and equivalent to 30 grams per day. An uncontrolled study noted increased symptoms with insoluble fibers. It is unclear if these symptoms are truly increased compared with a control group. If the symptoms are increased, it is unclear if these patients were diarrhea predominant (which can be exacerbated by insoluble fiber), or if the increase is temporary before benefit occurs.
Medication
Medications may consist of stool softeners and laxatives in constipation-predominant IBS, and antidiarrheals (e.g., opiate, opioid, or opioid analogs such as loperamide, codeine, diphenoxylate) in diarrhea-predominant IBS for mild symptoms.Drugs affecting serotonin (5-HT) in the intestines can help reduce symptoms. Serotonin stimulates the gut motility and so agonists can help constipation-predominate irritable bowel, while antagonists can help diarrhea-predominant irritable bowel. (Magusba.blogspot.com)
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thanks, i just want to share some articles that looked important for us..
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