Psychological food aversion is much more common than true food intolerance and it has been difficult to prove that physical intolerances exist. Options for treatment Treatment for IBS is symptomatic as there is no cure. For many patients, an explanation of the origin of symptoms and a reassurance that it is not a serious condition will be enough to allow the patients to live with the symptoms. Emphasis on the fact there is no underlying pathology is extremely important. Fibre Pharmacists can advise patients to include more fibre in their diet or to take bulking agents, such as bran, ispaghula or sterculia, or synthetic alternatives, such as methycellulose.
Many gastroenterologists recommend trying dietary manipulation before resorting to bulking agents.
The most effective drugs for relieving the abdominal pain of IBS are the anti-spasmodics, which work by reducing the spasm of the muscles in the intestinal tract. They work by damping the transmission of nerve signals to the bowel wall, blocking the action of acetylcholine and relaxing the intestinal wall muscles. Their use is associated with a high incidence of cholinergic side-effects such as dry mouth and blurred vision. They are contra-indicated in glaucoma, prostate hypertrophy and intestinal obstruction. Dose titration is recommended in the elderly.