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Integrative approaches to reduce IBS symptoms

February 11, 2019

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photo of Michelle Dossett, MD, PhD, MPH

Michelle Dossett, MD, PhD, MPH, Contributor

Michelle Dossett, MD, PhD, MPH is an assistant physician and clinical researcher at the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital and an Assistant Professor of Medicine at Harvard Medical School. She board-certified … See Full Bio
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Shelly Marie
February 23, 2019

Ok everyone: here’s a crazy solution and I’ve found it actually helps. We need to redirect. I think it’s actually a psychological term of sorts. I find I get so worried at work when I’m getting diarrhea that I’m going to have an accident. I sit there getting angry too that I’m going through this once again… so I do something completely different. I take the 4 dose Imodium. Hit the bathroom where I’ll be for a while, and read a Historic Romance Novel. I’m not kidding. It completely takes my stress-filled mind off my present trouble. I completely relax and forget my IBS, getting caught up in the story. Redirect your mind to something completely different. It just might work. The IBS attack comes to a close and it’s no longer the enemy of my day.

February 21, 2019

Thank you for this article Dr. Dossett. As a Registered Nurse working with integrative therapies that are evidence-based as adjuncts to conventional medicine, I have found the stress relief offered through meditation, mindfulness, hypnosis and reiki helpful for reducing symptoms in clients with IBS, and other digestive issues, especially when taught these as helpful ‘tools for self-care.’ A number of clinicians in the U.S. offer hypnosis as adjunctive/supportive therapy for IBS.

While admittedly difficult, if not impossible to blind patients when studying these therapies, this review of randomized-controlled studies concluded that “hypnotherapy has beneficial short-term effects in improving gastrointestinal symptoms of patients with IBS.”
(J Neurogastroenterol Motil 2014;20:152-162)

Michelle Dossett, MD, PhD, MPH
February 21, 2019

You’re welcome, Karen. And thank you for sharing about hypnotherapy. You are correct. There is a particular form of hypnotherapy (gut-directed hypnotherapy) that was developed in the UK (also known as the Manchester protocol) that has good data behind it for helping with IBS-related symptoms. I haven’t seen it used much in the US.

Pat Pauley
February 21, 2019

I’ve had IBS since I was in my early twenties. Primarily diarrhea, very rarely constipation or bloating. Have tried numerous meds., diets, fodmap included, probiotics, etc. etc. Nothing has helped much. I did learn that one of my BP meds was exacerbating the diarrhea, so discontinuing that has been helpful. I take a Lomotil almost everyday, which lasts for several hours, so that I can enjoy a few activities outside my house. I am 73 and frankly, I’ve given up on trying to control this disorder. I have tried every suggestion made in this online newsletter. I am tired and old and cannot enjoy traveling or other activities that I thought I might be able to do in my retirement. Essentially, this disorder has controlled my life.

February 19, 2019

I had IBS associated with extended use of antibiotic. It happened, even though I was taking a multi-strain probiotic. Recently, I read about a study that showed a multi-strain probiotic interfered with the microbiome returning to normal.

I found Florastor (a single strain yeast) helpful for my mild case of IBSD. I discontinued it after pain subsided. I also thought that rinsing my salad with a vinegar / water solution also helped, and continue to do that.

February 19, 2019

Have you considered digestive aids? I have found broad spectrum helpful.

February 18, 2019

I find a little OTC Imodium helpful for loose BMs:
as well as a tiny dose 5-10mg of rx’d amitryptiline
The latter is long acting whereas Imodium starts working in an hour +…..
With the above I can be comfortable after the first couple of hours of the day. Of course there are many variables: what you eat (too much fiber), alcohol, Vit C, too much aspirin, and of course stress is the big one… I too run to relieve stress once my gut feels better. In a perfect world I would slow pace & meditate…..
The biggest problem with the above medications is occasionally getting a little constipated temporarily which is also no good when you’re accustoned to being too loose! Work with the dosaging being aware that Imodium wears off (see directions on label) whereas amitryptine is taken just once or twice a day… People in general vary widely in their sensitivity to the dosages above, So trial and error are required: son, however, you get to know your gut and your ‘head..!’… Chill… is the bottom line, but so hard for many of us to do !! Eating less also helps along with less alcohol. Oh: avoid hot liquids: coffee is the worst: remember most people (without loose IBS) use coffee as a mild laxative every morning the world over! Take Grren Tea capsules if you want the harmless caffeine (or even a No Doz); it’s Not the caffeine that stimulates peristalsis: tea is not as strong (But sone people just drink hot water as a laxative…:-). Coffee is the 1st thing to give up: get your harmless dose of caffeine elsewhere… I know, I know… the coffee smells so good!! I have it up 25 years ago! (Except as a treat if I get constipated by a little too much Imodium!!) (Even then glyce

February 18, 2019

It’s helpful to keep track of the food you ate when you had a problem. I found that oats are not good for me even though they are always on lists of foods you should eat if you have IBS.

Kathy Moreland
February 18, 2019

I am grateful for any suggestions to help me with my IBSD. I started having this after gallbladder surgery. Through the years I’ve taken different meds. And they help for awhile but changes after time.
My NP suggested I try a gluten free diet and I do try and stick to a gluten free diet but reall hasn’t changed that much. I’m ready to try what you suggest. I’m 76 years old and IBSD leaves me weak and no energy so I hope this will help and I thank you

Barbara Forman
February 18, 2019

How can I choose a great probiotic?

Michelle Dossett, MD, PhD, MPH
February 19, 2019

Unfortunately, it is not a straightforward answer. Different probiotic organisms may be better for different things. In general, I recommend one with a variety of different organisms (including Bifidobacterium) and a larger number of organisms (something in the 30-50 billion range or more). Probiotics also need prebiotics in the form of what we consume in our diet to thrive. Plant-based foods are generally very good for this. Final thing to know is that not all probiotics contain what they claim to. Consumer Labs periodically analyses probiotics and reports on which ones contain what they claim and which ones don’t.

February 15, 2019

I tried everything I could think of or find on the internet and the only thing that helps me is running. I run 5km every other day and my symptoms have pretty much disappeared. If I stop running though for even a week the stomach pain comes back and the diarrhea/constipation starts. I was diagnosed with IBS 8 years ago. My advice, GET MOVING! You probably feel terrible and afraid to leave your house too long so just go around the block.

February 18, 2019

Hi, so glad exercise is helpful for you but for me exercise can REALLY trigger a bad bout of horrible cramping and explosive diarrhea. I’ve already had to rush out of the gym to the bathroom where I’m stuck for a half hour or so. Even walking too fast can trigger these bouts as well. I’m trying to find some way to fix this but nothing has worked so far.

Michelle Dossett, MD, PhD, MPH
February 19, 2019

So glad you found running helpful. Exercise is a great buffer for stress and it also helps to reduce constipation. Others may need to try something else. The causes and solutions for IBS are multifactorial which is why I individualize treatment based on the person in front of me.

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