IBS is defined as a collection of symptoms like abdominal pain, bloating, flatulence, and diarrhea or constipation. The first step in diagnosing it is ruling out conditions (such as a food allergy) that produce IBS-like symptoms. Because recent research has linked IBS to bacterial overgrowth in the small intestine, I recommend you get a lactulose breath test at your gastroenterologist's office. It's a noninvasive measurement of hydrogen and methane gases, which are overproduced if there is too much bacteria in the gut. If your test is positive, your doctor may suggest you take Xifaxan, a nonabsorbable (so it stays in the gut) antibiotic. Whether you experience diarrhea or constipation, drink eight to ten glasses of water a day to help alleviate both extremes. Also try to eat 25 to 40 grams of soluble fiber (bran is a good source) every day.
—A.A. Starpoli, M.D., a gastroenterologist at St. Vincent's Catholic Medical Center and Lenox Hill Hospital in New York City
An irritable bowel is caused by weakened qi in the spleen, stomach, and kidneys. Try weekly acupuncture and acupressure to restore the flow of qi in those organs. For diarrhea, I may also perform moxibustion by holding the lit tip of a roll of moxa, or mugwort herb, above acupoints for a few minutes. The heat facilitates the flow of qi and strengthens loose bowels. For constipation, take Dang shen (codonopsis root) for improved bowel movement. To reduce diarrhea, try Si Jun Zi Tang (Four Gentleman Decoction), a Traditional Chinese Medicine formula that contains roots like ginseng, which can strengthen the spleen. Both are available as capsules in Asian herbal stores. Your acupuncturist will determine the dosage, which is client-specific. Also, once a professional has taught you the acupoints, you can try acupressure. Begin with Zu San Li (stomach point 36), about four fingers below the knee.
If you haven't responded well to conventional treatment or you want to supplement it, try gut-directed hypnotherapy, which disrupts the IBS pattern and allows your body to remember what a healthy gastrointestinal function feels like. Studies have reported success rates of 70 to 80 percent among IBS sufferers. In the most cited study, published in The Lancet, 15 patients undergoing hypnosis reported significant improvement with all IBS symptoms, while the control group (undergoing psychotherapy and taking a placebo pill) improved in only some areas. Hypnotherapists will typically see you for seven to ten half-hour sessions, during which you visualize images like the clearing of a stream blocked by debris (symbolizing the removal of digestive obstacles) and a log cabin with a burning fireplace (a well-functioning system). Also try meditating for at least ten minutes a day.
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