Typically, the low FODMAP diet involves two phases: the elimination phase, in which FODMAPs are fully removed from the diet, and the reintroduction phase in which foods are reintroduced, one by one and symptoms monitored. The goal of dietary therapy for IBS is to remove ‘trigger’ foods whilst maintaining adequate nutrition. It is therefore recommended that a nutritionist be consulted to ensure adequate nutrition whilst on the low FODMAP diet.
2) Mind-body interventions
The cause of IBS is not fully understood. However, there appears to be a susceptibility for the bowel to overreact to certain triggers such as stress and emotional trauma. For this reason, psychological therapies have been tested and found highly effective in treating patients with IBS. These include:
Gut-directed hypnotherapy: involves relaxation and suggestions to help IBS patients feel more positively about the sensations in the body. Working on the gut-brain connection, this therapy reduces pain signals and desensitizes the gut to digestive processes.
Cognitive-behavioral therapy (CBT): is a form of psychotherapy in which patients are taught to challenge negative thoughts associated with IBS, and adopt a more positive outlook. By reducing the stress response and negative mood, symptoms of IBS have been shown to improve.
Mindfulness meditation: is a form of Buddhist training in which patients are taught to accept the sensations in their bodies and appraise them without judgment.By bringing the patient’s awareness to the present moment, this form of therapy helps to reduce negative thoughts associated with IBS that may worsen symptoms
3) Medication for spastic colon
Several medications are commonly prescribed for spastic colon/IBS. These include:
Fiber supplements: such as psyllium (Metamucil) to improve symptoms of constipation in constipation-predominant IBS.
Laxatives: such as polyethylene glycol and lactulose can improve motility in IBS with constipation.
Anti-diarrheal medications: such as loperamide (Imodium) can improve symptoms of diarrhea-predominant IBS.
Pain medications: such asPregabalin (Lyrica) can reduce abdominal pain in IBS.
Antidepressants: such as tricyclic antidepressants, imipramine and desipramine, and SSRI medications, fluoxetine and paroxetine may reduce abdominal pain in IBS. These medicines work by lessening the pain signals from the intestines to the brain.
IBS-specific medications: such as alosetron work by relaxing the colon to slow the movement of digested material in IBS with diarrhea. Other drugs such as linaclotide work by relaxing the colon and increasing fluid secretion in the small intestines, to improve motility in IBS with constipation.
Probiotics: by improving the constituency of microbes in the gut, probiotics containing live bacterial species such as Bifidobacterium may improve IBS symptoms with limited side effects. However, this research is preliminary.
Antispasmodic medications: such as dicyclomine (Bentyl) may relieve stomach cramps and abdominal pain in IBS by relaxing the smooth muscles of the gut.
The Wrap Up
Spasming of the colon is common and usually associated with IBS but can also occur with other health conditions. If you are experiencing abdominal discomfort, cramping or diarrhea for an extended period it is important to discuss your symptoms with your doctor. If you are experiencing a spastic colon due to IBS you can manage this symptom through dietary changes such as the low FODMAP diet, through mind-body interventions such as hypnotherapy, or through medication.
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