Irritable bowel syndrome (IBS, or spastic colon) : Irritable bowel syndrome (IBS, or spastic colon) is a symptom-based diagnosis characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits
TREATMENT
Diet
Reduction of fructose and fructan has been shown to reduce IBS symptoms in a dose-dependent manner in patients with fructose malabsorption and IBS.
Fiber
Some evidence suggests that soluble fiber supplementation (e.g., psyllium/ispagula husk) is effective in the general IBS population.
Medication
Medications may consist of stool softeners and laxatives in constipation-predominant IBS and antidiarrheals (e.g., opiate, opioid, or opioid analogs such as loperamide, codeine, diphenoxylate) in diarrhea-predominant IBS for mild symptoms and stronger opiates such as morphine and oxycodone for severe cases.
Drugs affecting serotonin (5-HT) in the intestines can help reduce symptoms. 5HT3 antagonists such as ondansetron are effective in postinfectious IBS and diarrhoea-dominant IBS due to their blockade of serotonin on 5HT3 receptors in the gut.
Laxatives
For patients who do not adequately respond to dietary fiber, osmotic laxatives such as polyethylene glycol, sorbitol, and lactulose can help avoid "cathartic colon" which has been associated with stimulant laxatives
Antispasmodics
The use of antispasmodic drugs (e.g., anticholinergics such as hyoscyamine or dicyclomine) may help patients, especially those with cramps or diarrhea
Serotonin agonists
Tegaserod (Zelnorm), a selective 5-HT4 agonist for IBS-C, is available for relieving IBS constipation in women and chronic idiopathic constipation in men and women.
Other agents
Magnesium aluminum silicates and alverine citrate drugs can be effective for irritable bowel syndrome.