1. One common mistake that most people make is that of serving all kinds of foods in a dinner. This is really a big mistake. As an example, if your dinner consists of meat, you should not eat starchy foods or grains with it. The reason behind this is that the enzyme used by our body to break fat is different than the one used to break grains and starch. As you can see, if you eat meat along with starch, your body really gets confused as to which type of enzyme to use in order to break down the food. In short, your body experiences grave uneasiness. This in turn causes ibs. As a rule of thumb, you should eat meat only with a vegetable or a vegetarian meal. This is the easiest way to cure ibs fast.

2. Another mistake that people make is that they eat fruits immediately after having a meal. Fruit must never be served after a meal, because fruits, as a rule, digest faster than all other types of foods. So, if you eat fruits immediately after having your meal, they are all mixed up together in one place which in turn slows down the digestion process. If you want to eat fruits, I would suggest that you eat fruits at least half-an-hour before having a meal or as a snack in between meals.

3. Many people make the mistake of drinking beverages along with meal. Drinking liquids with meal is a bad idea because it creates confusion for the body. Just think about it: when you eat food your body gets the signal that the food is coming and it gets ready with all the enzymes to digest that food. Now say, you drink a beverage in the middle of having your meal. Now, your body gets confused because instead of food, it is now receiving liquids. This confusion can negatively affect your digestion process. I would suggest that you don’t drink beverages during meal time. If you really want to have beverages, try a digestive enzyme supplement instead.

Staying IBS-Free

Although there are no definite treatments for IBS, there are some things that you can do to avoid experiencing this condition while you are at buffet parties, and that is by avoiding certain trigger foods. Trigger foods are the type of foods that can help cause or lead to the different symptoms that an IBS sufferer may experience. By eating certain types of foods, IBS sufferers may feel that their IBS symptoms have become very troublesome, especially since certain foods can trigger the symptoms, causing the walls of the bowel to contract and become inflamed. By avoiding these trigger foods, you can avoid experiencing IBS during the party.

An example of trigger foods that IBS sufferers should try to avoid would be those that have dairy in them. This should be observed, especially for those people who are lactose intolerant, since eating dairy food can cause pain and flatulence. When in buffet parties, try to avoid foods that have dairy in them, such as certain salad dressings, packaged foods like breads, instant potatoes, and even some form of soups.

Another trigger that should be avoided would be carbonated beverages and alcohol, such as sodas pops, sparkling water, beer and wine, since these types of trigger foods can cause an IBS sufferer to experience gas due to the undigested gas bubbles in the bowel. Alcohol can even cause irritation to the GI system, and can dehydrate the entire digestive system. Although buffet parties will have plenty of alcohol and carbonated beverages, it would be best if you steer clear of these in order to avoid your IBS symptoms from occurring.

Fats, which include artificial fats, should also be avoided since these can cause indigestion, diarrhea and flatulence to an IBS sufferer. It can also increase the peristaltic activity of the bowel, thereby creating more frequent bowel movements. It is important to try and avoid this type of trigger food since fats are not easily absorbed by the digestive tract, which is why it can easily lead to a number of the symptoms of IBS.

You can also try to reduce or eliminate the chances of you experiencing painful gas again by avoiding certain foods that can help lead to that particular symptom of IBS, such as beans, onions, garlic, broccoli, cabbage, brussels sprouts, asparagus and cauliflower.

“While the precise prevalence and incidence depends on the criteria used, all studies agree that it is a common disorder, affecting a substantial proportion of individuals in the general population, and presenting frequently to general practitioners and to specialists,” write Robin Spiller, MD, from the University Hospital in Nottingham, United Kingdom, and colleagues.

“IBS is troublesome, with a significant negative impact on quality of life and social functioning in many patients, but is not known to be associated with the development of serious disease or with excess mortality. IBS generates significant healthcare costs both direct, due to IBS symptoms and associated disorders as well as indirect, due to time off work.”

In most countries, IBS affects 5% to 11% of the population, with prevalence peaking from age 20 to 45 years with a female predominance (female:male ratio approximately 2:1). The disorder may account for approximately 3% of all consultations referred from primary care.

The current recommendations were issued at the request of the Chairman of the Clinical Services Committee of The British Society of Gastroenterology to provide guidelines for the evaluation and treatment of adult patients with IBS. Members of the committee were assigned specific areas to review. Literature search of PubMed, EMBASE, MEDLINE, Web of Science, and Cochrane databases and search of extensive personal reference databases focused on high-quality studies that used established methodology and substantial patient numbers with clearly defined entry criteria. Criteria for inclusion of treatment trials were randomization and placebo control.

The predominant bowel habit (diarrhea or constipation) is a useful classification scheme. When diarrhea is a prominent feature, few investigations are needed, although alarm features may warrant further investigations.

Careful attention to history is of vital importance to the diagnosis. Abdominal pain or discomfort is typically relieved by defecation and associated with change in stool form (usually looser) and change in stool frequency.

Associated features that may be helpful in making the diagnosis include frequent consultation for medically unexplained symptoms, somatization, and past history of anxiety or depression. Psychological assessment to evaluate current anxiety and depressive symptoms is also important.

The presence of alarm symptoms, though nonspecific, should mandate further investigations. These include age older than 50 years, symptom duration less than 6 months, weight loss, nocturnal symptoms, family history of colon cancer, rectal bleeding, anemia, and recent antibiotic usage.

When these alarm symptoms are present, further investigations may be useful in primary care settings. Before these are undertaken, however, patients should be told that IBS is the most likely diagnosis and that these tests are designed to rule out celiac and inflammatory bowel disease. Useful tests may include full blood count and erythrocyte sedimentation rate, as well as testing for endomysial antibodies.

Many patients fear that their symptoms may reflect serious disease. These fears should be elicited and specifically addressed in an adequate consultation including exploration of patient anxieties and concerns.

Because of accompanying adverse psychological features and somatization, IBS is often best managed by evaluating the patients’ concerns and explaining symptoms in simple terms the patient can understand. Giving the patient a positive diagnosis and reassuring them of the benign nature of IBS without denying the significance of their symptoms tends to improve outcomes. Treatment of associated anxiety and depression often improves bowel and other symptoms.

Irritable bowel syndrome is a heterogeneous condition with a wide spectrum of treatments, each benefiting a small proportion of patients. Dietary management should begin with a thorough dietary history and moderation of excessive consumption of any 1 component. If intake of lactose, wheat, and/or insoluble fiber appears to be above average for the population, trial exclusion of these foods may be helpful.

Psychological therapies should be first-line treatment when anxiety, panic attacks, and depression are prominent features. Based on evidence from randomized placebo-controlled trials, cognitive behavioral therapy and psychodynamic interpersonal therapy improve coping, and hypnotherapy benefits global symptoms in otherwise refractory patients. Relaxation therapy may also be beneficial.

In terms of drug therapies, antispasmodic drugs are safe, but offer only a small improvement relative to placebo. Soluble fiber supplements may benefit those with constipation, whereas bran and other insoluble fiber may aggravate symptoms.

Loperamide is helpful for symptoms of urgency and frequency but may exacerbate abdominal pain and discomfort. Antispasmodic and tricyclic antidepressant drugs improve pain, whereas ispaghula improves pain and bowel habit.

Although 5HT₃ antagonists improve global symptoms, diarrhea, and pain, they may rarely cause unexplained colitis. 5HT₄ Agonists improve global symptoms, constipation, and bloating, whereas selective serotonin reuptake inhibitors improve global symptoms.

“Patients [with IBS] comprise such a large proportion of gastroenterology outpatients that their streamlined and effective management would impact favourably on any gastroenterology department’s overall performance and hence improve the management of all GI [gastrointestinal] diseases,” the authors write. “Better ways of identifying which patients will respond to specific treatments are urgently needed.”

Warning signs indicating that the primary care clinician should refer the patient with suspected IBS to a specialist are as follows:

• Rectal bleeding requires rectal examination and usually referral for a flexible sigmoidoscopic examination
• Presence of several alarm features
• Uncertainty concerning the diagnosis
• Failure to respond to initial management strategies
• Disabling health-related anxiety
• Long-standing symptoms with impaired quality of life

The authors have disclosed various financial relationships with Novartis, Mundi Pharma, GlaxoSmithKline, Pfizer Pharmaceuticals, Eli Lilley & Co, Solvay, Clasado, AstraZeneca, Tillots Pharma, Ferring, Rotta Research, Proctor & Gamble, and/or Astellas.

Gut. Published online May 8, 2007.

Clinical Context

IBS is a chronic, relapsing gastrointestinal syndrome, with key features of abdominal pain, bloating, and changes in bowel movements. IBS has a high prevalence in the general population and is seen commonly in clinical practice both by general practitioners and by specialists.

Although IBS is not known to lead to serious disease or excess mortality, it has a significant negative impact on quality of life and social functioning and generates significant direct and indirect healthcare costs. The Chairman of the Clinical Services Committee of The British Society of Gastroenterology convened an expert panel to provide guidelines for the evaluation and treatment of adult patients with IBS.

Study Highlights

• When diarrhea is a prominent feature of IBS, few investigations are needed unless alarm features are present.
• Diagnosis is made by history of abdominal pain or discomfort typically relieved by defecation and associated with change in stool form (usually looser) and in stool frequency.
• Associated features that may aid in diagnosis include frequent consultation for medically unexplained symptoms, somatization, and past history of anxiety or depression. Psychological assessment should evaluate current anxiety and depressive symptoms.
• Alarm features mandating further investigations include age older than 50 years, symptom duration less than 6 months, weight loss, nocturnal symptoms, family history of colon cancer, rectal bleeding, anemia, and recent antibiotic usage.
• Warning signs indicating that the primary care clinician should refer the patient with suspected IBS to a specialist include rectal bleeding (warrants referral for flexible sigmoidoscopy), presence of several alarm features, uncertainty concerning the diagnosis, failure to respond to initial management strategies, disabling health-related anxiety, and longstanding symptoms with impaired quality of life.
• Before additional testing (eg, for full blood count, erythrocyte sedimentation rate, and endomysial antibodies), patients should be told that IBS is the most likely diagnosis. Patients’ fears that their symptoms may reflect serious disease should be elicited and specifically addressed. Without denying the significance of their symptoms, giving the patient a positive diagnosis and reassuring them that IBS has a benign course tends to improve outcomes.
• Treatment of associated anxiety and depression often improves bowel and other symptoms.
• IBS is a heterogeneous condition with a wide spectrum of treatments including dietary modifications and psychological and pharmacologic therapies. Each of these therapeutic approaches benefits a small proportion of patients.
• Dietary management should begin with moderation of excessive consumption of any 1 component, especially lactose, wheat, and/or insoluble fiber.
• When anxiety, panic attacks, and depression are key symptoms, psychological therapies should be first-line treatment, including cognitive behavioral therapy and psychodynamic interpersonal therapy to improve coping, hypnotherapy to reduce global symptoms in otherwise refractory patients, and relaxation therapy.
• Antispasmodic drugs are safe but only slightly more effective than placebo. Soluble fiber supplements may improve constipation, but bran and other insoluble fiber may aggravate symptoms.
• Loperamide may reduce urgency and frequency but increase abdominal pain and discomfort. Antispasmodic and tricyclic antidepressant drugs improve pain, and ispaghula improves pain and bowel habit.
• 5HT₃ Antagonists improve global symptoms, diarrhea, and pain but may rarely cause unexplained colitis. 5HT₄ Agonists improve global symptoms, constipation, and bloating, while selective serotonin reuptake inhibitors improve global symptoms.

Pearls for Practice

• The primary care clinician should refer the patient with suspected IBS to a specialist for rectal bleeding (for flexible sigmoidoscopy), presence of several alarm features, uncertainty concerning the diagnosis, failure to respond to initial management strategies, disabling health-related anxiety, and longstanding symptoms with impaired quality of life.
• Treatments of IBS may be dietary (moderation of lactose, wheat, and/or insoluble fiber), psychological (first-line therapy when psychiatric symptoms present), or pharmacologic (may be effective but aggravate some symptoms), each benefiting a small proportion of patients.

Article Source: Medscape