Spastic colon (a.k.a. irritable bowel syndrome)

Dear Helping son and IBS sufferer,

Spastic colon, otherwise known as irritable bowel syndrome (IBS), can be a frustrating condition to manage. Luckily, it’s a common disorder seen by health care providers so there are multiple strategies that can be employed to help you alleviate symptoms and manage the disorder (more on this in a bit). Before addressing strategies, it might help to start with a little more information on possible symptoms and causes of IBS.

IBS is typically characterized by diarrhea, constipation, or alternating bouts of both. Other symptoms include abdominal pain or swelling, feelings of excessive fullness, gas, painful bowel movements, and mucus in the stool. Sometimes these symptoms can occur with other disorders so it’s recommended that people consult a health care provider if they’re experiencing symptoms. IBS usually develops in late adolescence or early adulthood. Although the exact cause is unknown, certain foods or stress may trigger symptom flare ups. Hormonal changes are also thought to be a factor as symptoms can be worse during or around menstrual periods. Other factors, such as stronger or weaker than normal muscle contractions in the gastrointestinal (GI) system or uncoordinated signals sent between the brain and the gut, may result in increased pain and discomfort.

Helping son, you say that your father was told his pains could be symptoms of a spastic colon (a.k.a., IBS). It's not clear who gave him this information, but it’s recommended that a diagnosis of IBS come from a health care provider after they’ve been able to take a health history, perform a physical exam, and complete certain diagnostic tests. Doing so may help your father identify the cause of his discomfort and learn about the most effective treatment options. Once diagnosed managing IBS involves simple changes in a person's eating plan and lifestyle, under the guidance of a health care provider or registered dietitian. This handful of suggestions might also offer some relief:

• Increase fiber intake. Fiber helps reduce spasms and promotes regular bowel movements. Unfortunately, it can also exacerbate diarrhea, gas, bloating, and cramping. To combat this, try gradually increasing the amount of fiber over a few weeks. This will help to allow the body to adjust. Some foods high in fiber are whole grains, fruits, vegetables, and beans.
• Minimize or manage stress. If stress triggers signs and symptoms of IBS, activities such as biofeedback, mindfulness training, deep breathing exercises, or counseling may offer relief and strengthen coping skills. Even simple relaxation activities like reading, taking a bath, or listening to music may also help.
• Avoid trigger foods. If you experience bloating or gas, you might want to avoid broccoli, cabbage, cauliflower, beans, or any other foods that cause discomfort. Other foods that tend to trigger symptoms may include alcohol, coffee, soda, chocolate, fatty foods, dairy products, and some sugar-free sweeteners.
• Eat regularly. Eating at about the same time every day can promote regular bowel function. If diarrhea is a problem, eating small, frequent meals can help. For constipation, eat larger amounts of high-fiber foods to help move things along.
• Make exercise routine. In addition to reducing stress and feelings of depression, getting regular physical activity may also stimulate normal muscle contractions in your intestines. If you’re new to working out, it’s best to start slow and consult your health care provider about how to begin.
• Drink plenty of water. Water can help fight dehydration or make stools softer and easier to pass. Also, make sure to drink plenty of water when increasing fiber intake to reduce gas, bloating, and constipation.
• Explore other options. The use of acupuncture, peppermint, hypnosis, probiotics, yoga, and meditation show promise at managing symptoms and reducing pain.
• Use medications if/as prescribed. Antispasmodics may be prescribed to reduce cramping, tranquilizers for temporary relief of anxiety, anti-diarrheal medications for diarrhea, antidepressants for abdominal pain and depression, and bulk laxatives (high in fiber) or stool softeners to relieve constipation, if/when it's necessary. When taking anti-diarrheal medications and laxatives, use the lowest dose that works since these drugs can cause dependency and problems in the long-term.

IBS sufferer, you shared that you have been put on medications but they haven't helped. Along with those mentioned above, there are two prescription medications specifically for IBS. The first is alosetron, which helps to relax the colon and slow things down in the bowel. This medication is typically only used when other treatment options have failed. Due to its rare, but significant side effects, it’s only approved for women with diarrhea-predominant IBS and you must be enrolled in a special program. The second medication is lubiprostone and is only approved for women who suffer from IBS with constipation. This one increases fluids in the small intestine, which then helps the passage of stool.

If you want to learn more about possible medications and managing symptoms, it's recommended that you check in with your health care provider as they can help you find other treatment options if the strategies you’ve been using aren’t helping. Helping son, you might also try asking your dad if it would be helpful to go with him to his appointment, so you can learn as much as you can about his condition. Sometimes people minimize their symptoms (or pain) and may not always accurately hear the treatment plan. This is where you can help by being a supportive listener and encouraging your father to follow the advice of the health care provider.

While annoying at times, this is a medical condition that, with proper care, can be managed. For even more information on IBS, check out the National Digestive Diseases Information Clearinghouse (NDDIC).