Simple Treatments May Still Help Irritable Bowel
Some find success for hard-to-treat symptoms with traditional therapies

(HealthDay News) -- Traditional, old-line treatments -- including peppermint oil and fiber -- might be better than new, high-priced drugs for treating irritable bowel syndrome.

People with the syndrome, often called IBS, generally have significant pain and discomfort along with chronic or recurrent constipation -- or bouts of both. The exact cause of IBS isn't known, but it's believed to be the result of a disturbance in the interaction of the gut, brain and nervous system, according to the International Foundation for Functional Gastrointestinal Disorders. As many as 45 million Americans are thought to have the condition. There is no cure.

"IBS can be difficult for physicians to treat," Dr. Alex Ford, of McMaster University Health Sciences Centre in Hamilton, Ontario, Canada, told HealthDay. "New drugs are always being developed, but recent ones such as alosetron and tegaserod have been withdrawn and are now only available on a restricted basis, and renzapride has not been shown to be effective."

In contrast, "older drugs, which are cheap, safe, and in some cases available over the counter, appear to be effective in IBS," Ford added.

He led a review that looked at clinical trials that compared older treatments -- antispasmodics, fiber and peppermint oil -- to a placebo or no treatment. In total, the studies included more than 2,500 participants.

Reporting in BMJ, the researchers concluded that fiber, antispasmodics and peppermint oil were effective treatments for IBS. To prevent IBS symptoms in one person, they found, 11 needed to be treated with fiber, five with antispasmodics and 2.5 with peppermint oil.

That put peppermint oil at the top of the list. Insoluble fiber such as bran was not shown to be effective, but soluble fiber, such as ispaghula husk (psyllium), reduced IBS symptoms.

"Physicians, particularly those in primary care who are being asked to take increasing responsibility for the management of IBS, should consider the use of these agents as first-line therapies for IBS," Ford said.

Dr. Roger Jones, of King's College London, told HealthDay that the older treatments highlighted in the study "might be slightly more effective than recently thought, and they are worth trying."

Jones suggested, "If you have IBS which is not under reasonably good control or you are not happy with your symptoms profile, you should see your primary care doc or gastroenterologist for review and perhaps remind them that there is new evidence about the effectiveness of these traditional medicines and you would like to give it a go."

Alternatively, he added, "if you feel sufficiently well-informed and confident, you can go do it yourself and get these treatments at the pharmacy."

Many people have IBS for a long time before they see a doctor for help, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. In fact, it says that an estimated 70 percent of Americans with IBS are not receiving medical care for their symptoms.

On the Web

To learn more about managing irritable bowel syndrome, visit the American Academy of Family Physicians.

SOURCES: HealthDay News ; Alex Ford, M.D., McMaster University, Health Sciences Centre, Hamilton, Ontario, Canada; Roger Jones, M.D., King's College London, England; Nov. 14, 2008, BMJ, online; U.S. National Institute of Diabetes and Digestive and Kidney Diseases (www.niddk.nih.gov)
Author: Robert Preidt
Publication Date: Nov. 30, 2009
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