Irritable Bowel Syndrome: No Cure, But a Variety of Treatments

Q:  I am a 49-year-old Asian woman who has been told that I have irritable bowel syndrome (IBS). Not only do I have constant bloating in the upper abdomen, but I also have lots of gas. Of course I have been examined by all of the tools: colonoscopy, x-rays, digestive test, and ultrasound. I read from the web that IBS is forever and cannot be cured. This is discouraging and makes me feel this is terminal.

Is IBS associated with menopause? Will the symptoms go away when I pass menopause? Is there any other type of treatment other than those listed in most of the articles I read about, for example Chinese medicine? Thank you in advance for your kind assistance/guidance.

A:  You are not alone and IBS is not terminal, but it is extremely frustrating for the 15% of the US population that suffers from it. No one knows why IBS is much more common in women (75% of IBS patients) and is usually diagnosed at a young age (under 50). With menopause, women often find that illnesses or symptoms get worse for awhile. Hormonal changes can also cause bloating and changes in bowel habits.

Abdominal pain with gas and bloating and abnormalities of the bowel movements are the major symptoms of IBS. At times the stools may be more frequent, loose, and contain mucus, but other times they are hard and require straining.

A variety of treatments work better with some patients than others. These include avoidance of gas-producing foods, anti-spasmodics, fiber, stool softeners, anti-diarrheals, anti-depressants, and calcium channel blockers. Last year a new medication, Lotronex, was released and seemed to help many women, but unfortunately resulted in some deaths, so was pulled off the market.

Gastroenterologists in Australia studied the use of Chinese herbs for treatment of IBS and published their findings in the November 11, 1998 issue of the Journal of the American Medical Association. About 3/4 of patients given the herbs rated their symptoms as improved, compared to only 1/3 of the patients on placebo. Unfortunately I can't just tell you to go buy this herb in a natural foods store, because the capsule they used contained 20 different Chinese herbs and was designed by a Chinese herbalist.

Since you are Asian, and over 80% of Asian adults do not possess the lactase enzyme and get gas and diarrhea from milk products, you might experiment with dietary changes (if you haven't already). Don't be discouraged.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.