Irritable Bowel Syndrome: Treatments Aren’t One-Size-Fits-All
Irritable bowel syndrome (IBS) is an often misunderstood and underdiagnosed condition that affects about 15.3 million people in the United States.
No one remedy works for all patients, so there’s a great medical need to develop new therapies for IBS, says Tara Altepeter, M.D., a gastroenterologist with the U.S. Food and Drug Administration (FDA). That’s why the FDA is working to bring more treatments to the market.
“There’s a lot of new research about the role of carbohydrates, and specifically a nutrient called polyols, in triggering irritable bowel syndrome in some patients,” Altepeter says. “In addition, researchers are more closely examining the role of dietary modification as a treatment for patients with IBS.”
What Is IBS?
IBS is a gastrointestinal disorder that affects the large intestine (colon) but doesn’t cause inflammation or permanent damage. Common symptoms of IBS include abdominal pain, bloating, cramping, excessive gas, mucous in the stool, and alterations in bowel habits (constipation and/or diarrhea).
The symptoms may come and go and can change in the same patient. Sometimes the pain from IBS can be so severe that it’s disabling, and patients can’t do routine things. Doctors don’t know what causes IBS, and there is no known cure.
Studies estimate that as many as 20% of Americans suffer from IBS. Many people may not know they have this gastrointestinal disorder. They might have occasional diarrhea and constipation and think it’s caused by something they ate, or a virus, so they don’t see a doctor to get a proper diagnosis. When they do, doctors must first rule out that the symptoms aren’t caused by a disease or another condition.
“There are many conditions that have a female or male predominance, but we don’t understand why women have a higher prevalence of IBS,” Altepeter says.
IBS is most common among people younger than 45, and patients usually first experience symptoms when they’re in their late 20s. People who have a family history of IBS are also more likely to develop the condition.
Depression, anxiety, and other psychological problems are common in people with IBS.
“Some people suffer from depression and IBS. The question is what’s primary or secondary – what came first?” Altepeter says. “Either way, antidepressants are not a cure for IBS.”
Treatments for IBS vary from patient to patient and include changes in diet, nutrition, and exercise. Some patients require medications to manage their symptoms. Others can find improvement with Cognitive Behavioral Therapy (CBT) or gut-directed hypnotherapy. Currently there are no medications that cure IBS.
“IBS is not like other chronic conditions, such as hypertension, which is constant. IBS is a variable condition. Even without treatment, the problem might go away in some patients. But the symptoms might return after a few months,” Altepeter says.
No one medication works for all people suffering from IBS.
IBS and Diet
“Drugs are a last option. Patients should try dietary modifications, relaxation techniques, and other lifestyle changes, such as exercise, before resorting to medication,” Altepeter says.
Certain foods and drinks can trigger IBS symptoms in some patients. The most common are foods rich in carbohydrates, spicy or fatty foods, milk products, coffee, alcohol, and caffeine.
IBS and Children
It’s difficult to diagnose IBS in children because its symptoms are so common and may be seen in a variety of conditions. Young children may not verbalize their symptoms the same way that teenagers or adults can. The National Digestive Diseases Information Clearinghouse (NDDIC) reports that one study of children in North America found that children are equally prone to having IBS. The study also found that as many as 14% of high school students and 6% of middle school students have IBS.
Diagnosing IBS in young children remains a challenge, as does its treatment. FDA has not approved any drugs for treating IBS symptoms in children.
Source: The Food and Drug Administration