One of the main problems Dr Ana Wilson experiences when treating functional bowel disorders is that the symptoms are broadly similar. For example, it can be difficult to separate the symptoms of IBS from the symptoms of food intolerance. Furthermore, many functional bowel problems are affected by psychological factors like stress, so it can be very hard to identify their individual impact.
In many cases, the main treatment for a functional bowel disorder is to identify the trigger for the symptoms and eliminate this from the diet. This involves a change of lifestyle, which is not always easy.
It also needs to be done with great care and caution, making sure that your overall diet is still giving you the nutrition you need and that the elimination measures are not too stressful.
As well as adopting the lifestyle and dietary changes Dr Wilson advices, she can also offer practical treatments to relieve some of the symptoms of IBS, such as altered bowel habit and depression. These include:
- Antispasmodic medicines such as mebeverine or therapeutic peppermint oil. These reduce bowel spasms and return the colon muscles to their natural function.
- Bulk forming laxatives such as methylcellulose or unprocessed bran. These make stools softer and denser for constipation sufferers, so that they can be passed more easily.
- Antimotility medication such as loperamide. These reduce the contractions of the muscles in the bowel wall, slowing the transit speed and allowing more water to be absorbed from the stool.
- Antidepressants such as selective seratonin reuptake inhibitors (SSRIs) such as flouxetine and paroxetine, and tricyclic antidepressants, such as amitriptyline. These help to reduce the anxiety associated with the discomfort and embarrassment of IBS and can be prescribed in severe cases.
- Psychological therapies. These are also used to treat IBS sufferers, where stress or other emotional triggers have been identified but that are not severe enough to warrant antidepressants. Counselling, cognitive behavioural therapy and psychodynamic interpersonal therapy can all help you cope with your condition.
Treating food allergies
Severe food allergies can cause anaphylactic shock, which can be life threatening and needs urgent treatment. Patients are advised to carry adrenaline with them so that it can be administered immediately in an emergency situation.
Some IgE allergic reactions are caused by excessive histamine production, and so anti-histamines are often effective in reducing mild to moderate symptoms.
Treating food intolerance
There are no known treatments for food intolerance other than the elimination of the food that causes the problem. However, this can itself cause problems of weight loss and malnutrition, especially in growing children. For example, an intolerance of dairy products can lead to a deficiency of minerals such as calcium, which are essential for bone development.
The treatment for food intolerance often requires expert nutritional advice from a qualified dietician in order to ensure that you still receive the right vitamins and minerals after you have removed certain foods from your diet.