Sun, 24 Aug 2003

Finding a treatment for irritable bowel syndrome

Claudine Frederik, The Jakarta Post, Jakarta

It is a very common health condition that disrupts the lives of sufferers, but too often irritable bowel syndrome (IBS) goes unrecognized by local physicians.

As most of us are reluctant to discuss bowel habits, those with IBS often suffer in silence.

Louise, who was recently diagnosed as an IBS patient at Citra Health Care Medical Center in Jakarta, described her ordeal of the last three months.

"I was already constipated before the operation. After neck surgery, my condition grew even worse. I noticed that my appetite gradually disappeared. Nothing seemed to be able to entice my taste buds. All I could do was drink, preferably sweet drinks. When I was released from hospital, the situation had not improved at all," she said.

"In the hospital, the nurses gave me an enema, but I did not notice any improvement after the treatment."

Seeking help from doctors for her constipation, weight loss and insomnia did not reap any results.

"Tablets to combat my stomach problem were prescribed but there was no change in my condition. I still shudder when I recall those dreadful days of utter inconvenience that I had to cope with for months."

With almost constant stomach spasms, Louise decided to seek a second opinion. This time she was diagnosed and treated for IBS. The embarrassing spasms disappeared overnight and normal sleep was restored in a couple of days. She hopes that she will regain her appetite soon.

According to Dr. Dirk Amidi of the health center, Louise's story is common as patients who come with stomach or abdominal complaints are frequently sent home with a prescription for standard medication.

IBS is not a stomach disorder but a problem involving a dysfunctional colon, Amidi said in a recent lecture in Malang, East Java.

Symptoms of the condition vary considerably. In some patients, they manifest in diarrhea but others like Louise suffer constipation. Severely affected patients suffer constant abdominal cramps which require that they always be aware of the location of the nearest toilet.

Some patients suffer extreme spasms of the colon without passing stool.

"The spasms usually subside if the patient has had a bowel movement. If that does not happen, the painful contractions keep returning." Amidi explained.

What causes IBS?

"IBS is actually a dormant condition of the bowel system. Some people who are endowed with a very sensitive bowel can promptly react to stimuli brought about by certain foods, stress or depression.

"Mind you, the problem is not caused by a faulty diet or stressful situation. Food and stress are triggers which set off irritable bowel syndrome in people vulnerable to the disease." Amidi said.

Symptoms of IBS appear in the form of gas, bloating, vomiting, constipation, poor appetite, pain, nausea, mucous or blood in stool, diarrhea and weight loss.

Amidi added that IBS is a common health problem in Asia -- including Indonesia -- and Africa. People who live in underdeveloped countries often fall victim to the disease because they do not eat properly or in a healthy way.

Also, certain people are more susceptible to IBS because of financial and emotional stress and also depression.

Amidi said that 40 percent of the local population suffered from one form of IBS or another. Sadly, many of these patients are often fobbed off with an all-encompassing diagnosis of an "upset stomach".

Is IBS curable?

The condition can be relieved by several methods: prescription medication, relaxation exercises or herbal treatments. The latter two have also become popular among foreign patients.

"For patients who are sensitive to certain foods, a good diet will do the trick, I'm sure. And if all methods fail, counseling with a psychiatrist has to be sought (for stress)," Amidi said.

The symptoms of IBS can be greatly reduced with the right treatment, although doctors in the U.S. are not at all certain that healing will be permanent.

For instance, a dietary change may be effective at one time, but the very same food item could set off a cramping reaction on another occasion.

Dr. Dirk Amidi said alcohol, coffee, dairy products, fats and psychological disturbances, such as emotional stress and depression, could trigger the condition.

He said that patients should determine what foods triggered IBS, especially after an attack of colon contractions. For example, they should jot down what they had for lunch or dinner, and try to ascertain the trigger.

A diet beneficial to most IBS patients consists of whole grain bread, cereals, beans, fruits, vegetables and most sources of fiber.

One type of food is gelatin, according to Amidi. Gelatin will slightly stretch the bowels and will in most cases block spasms of the colon.

In Indonesia, gelatin can be found in agar-agar (jelly), and is a basic ingredient in many local sweets. Patients should also get proper rest as this will reduce stress levels.

Treating the condition can be done through hypnotherapy, homeopathy, herbs, fennel seeds, virgin coconut oil, biofeedback, holistic treatments, peppermint oil and sticking to a low-fat diet.

Virgin coconut oil is prepared the traditional way, not in the refined modern process. The coconut meat is separated from the shell, and then the milk is squeezed out.

When the fat has separated, the oil can be cooked over a fire until it reaches a clear consistency.