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Irritable bowel complaints: some help, some not
Abdominal pain, flatulence, diarrhea, constipation: The symptoms of an irritable bowel are very non-specific and manifest themselves differently in those affected. While there is plenty of advice and recommendations for irritable bowel treatment, there is little scientifically proven. However, studies provide information on some means and measures that they can help.
Abdominal pain, constipation and diarrhea are typical complaints of irritable bowel syndrome (RDS), also called nervous bowel or irritable bowel, explains the Institute for Quality and Efficiency in Health Care (IQWiG) on the portal "gesundheitsinformation.de". Irritable bowel syndrome cannot be cured, but over time many people find out what is good for their gut and what is not. There are also several ways to relieve the symptoms.
Up to 15 percent of the population is affected
As the Gastro-Liga e.V. writes in a guide, irritable bowel syndrome is a very common digestive tract disease.
Ten to 15 percent of the population are affected, although the severity of the symptoms can vary greatly from person to person.
In some patients, symptoms appear only occasionally, for example with an unusual diet or when traveling.
But in about every second person affected, the complaints are so severe that medical advice is sought.
Little is scientifically proven
There is plenty of advice and recommendations for irritable bowel treatment - but only a few good studies overall, explains the IQWiG on "informedhealthonline.org".
According to the experts, one can say in summary: There is no treatment that will alleviate the symptoms safely. For some measures, however, studies have shown that they help at least some people or in the short term.
However, the research has also shown that side effects can occur, especially with medication.
However, many recommendations have not been well studied and their benefits are therefore questionable.
Peppermint oil is said to relax the intestinal muscles
As the IQWiG writes, peppermint oil is supposed to relax the intestinal muscles and thereby calm the intestines. In fact, some studies show that some people benefit from peppermint oil at least in the short term.
In the scientific studies, peppermint oil was ingested in gastro-resistant capsules. According to the information, the dosage was between 500 and 800 mg per day.
It is not clear whether peppermint solutions or drops also help. In nine out of 100 participants, the peppermint capsules triggered slight side effects such as heartburn or belching.
Probiotics can relieve symptoms
As the experts explain further, the intestinal flora contains various bacteria that play an important role in the functioning of the intestine. These include, for example, lactic acid bacteria (lactobacilli) and bifidobacteria.
Because the intestinal flora is changed in some people with an irritable bowel, it is believed that probiotic agents such as yogurts and drinks with such bacteria could help.
In some studies, probiotics were able to alleviate the symptoms in some of the participants. However, more research is needed to assess which type of bacteria is most useful and which dose works best.
In general, probiotics are well tolerated and minor side effects such as flatulence are rare.
People who are primarily concerned with cramps often use antispasmodic medication. These are intended to relax the intestinal muscles and thereby relieve pain.
There are indications that the active ingredient butylscopolamine available in Germany can help. It is offered over the counter in the pharmacy. In one study, this product was able to relieve irritable bowel symptoms in some patients.
Due to the lack of study results, it is not possible to say whether the anticonvulsant Mebeverin, which is often prescribed in this country, will help.
Possible side effects from such medicines include dry mouth, dizziness, and blurred vision. In studies, about five in 100 people reported such side effects.
Home remedies for diarrhea or constipation
According to the IQWiG, medications can also be used to treat symptoms such as constipation or diarrhea, but these have the disadvantage that they may only exchange one problem for another.
An anti-diarrheal remedy can cause constipation if it is too strong and vice versa, anti-constipation agents can cause diarrhea.
When diarrhea and constipation alternate, it is particularly important to make sure that the medication does not aggravate the symptoms.
In any case, it is possible in many cases to treat such symptoms naturally. There are various home remedies for diarrhea and constipation that work and have no side effects.
Because it is suspected that stress and psychological stress can contribute to irritable bowel syndrome, relaxation techniques and methods for coping with stress are used in some cases. However, it has not been sufficiently investigated whether these procedures can help.
However, some studies indicate that a combination of relaxation therapy, stress management and biofeedback could help.
It is also assumed that psychotherapeutic procedures such as cognitive behavioral therapy (CBT) can help with an irritable bowel.
And also for hypnosis treatment (hypnotherapy) there are indications that it can alleviate the symptoms in some people for a few months.
Acupuncture doesn't help
Many sufferers report that they feel better after acupuncture treatment. According to the IGWiG, however, a number of studies show that this is not due to a specific effect of acupuncture: acupuncture therefore showed no advantages over sham treatment.
Food diary can help identify intolerance
The experts also list some methods and agents that have not been studied and which are questionable as to whether they help or not.
Many people with irritable bowel syndrome notice that certain foods favor or alleviate the symptoms, but unfortunately there is very little good research on the influence of diet - which does not mean that it does not matter. How people react to certain foods is very individual.
It usually takes a while to find out what is good for you and what is not. It can help to keep a food diary for a few weeks, which records what you have eaten during the day, whether and what symptoms have arisen and which other factors have been added that could explain the symptoms (e.g. stress when work).
After a while, you may be able to identify certain patterns that help identify intolerance. The diary can then be used to discuss with the doctor whether it makes sense to forego certain foods.
No meaningful studies on the effectiveness of the FODMAP diet
In recent years, irritable bowel syndrome has been associated with foods that contain fermentable carbohydrates. These are known as FODMAPs and are found in numerous foods, such as fructose (simple sugar), milk sugar and starch (multiple sugar) or sweeteners (sugar alcohols).
With the so-called FODMAP diet, all foods that contain sugar are omitted. However, there is a risk of malnutrition as it becomes difficult to get enough vitamins and minerals. In addition, it is difficult to follow such a strict daily diet.
In addition, there are no meaningful studies to date that show that the FODMAP diet can relieve irritable bowel symptoms.
Rely on soluble fiber?
A balanced diet already contains sufficient amounts of fiber. It has not been proven that additional fiber supplements help.
If you still want to try fiber: In the case of irritable bowel syndrome, it is then recommended to eat more soluble fiber such as psyllium and to see whether they help.
Reflexology and colon irrigation
In irritable bowel syndrome, reflexology and colon irrigation (also called colon hydrotherapy) are used.
But as it says on "informedhealthonline.org", these two methods for irritable bowel syndrome have so far hardly been scientifically investigated. It is currently still unclear whether they will be of any use.
Experts point out that colonic irrigation has risks such as electrolyte imbalance, infections and injuries to the intestinal wall. (ad)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Institute for Quality and Efficiency in Health Care (IQWiG): Irritable bowel syndrome, (accessed: June 14, 2020), gesundheitsinformation.de
- Gastro-Liga e.V .: What you always wanted to know about irritable bowel syndrome, (accessed: June 14, 2020), Gastro-Liga e.V.
- Institute for Quality and Efficiency in Health Care (IQWiG): What helps with irritable bowel syndrome - and what doesn't ?, (accessed: June 14, 2020), gesundheitsinformation.de