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Self-Care Treatment for IBS-A

Strategies for Addressing the Challenges of Mixed Type IBS

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Updated August 15, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Treatment of alternating type irritable bowel syndrome (IBS-A) can be challenging due to the fact that bowel symptoms swing from diarrhea to constipation and back again. It is a common concern that steps taken to address one symptom will result in bringing on the unwanted other state of affairs. Further contributing to the problem is the fact that there is scant research focused directly on this "mixed-type" IBS. However, it is this writer's belief that there are steps that you can take to more comfortably manage your unpredictable and erratic intestinal system. The following suggestions are not research-supported, but are offered to serve as a possible guide to dealing with the frustrations of IBS-A.

Visualize a Functioning System

It is helpful to picture your intestinal system as a long freight train. With IBS-A, the train is careening out of control at times, and then stopped short at other times. Your goal is do whatever possible to encourage your system to move along at a regular pace, with periodic station stops. This means to take steps to calm the system when it is too agitated (diarrhea) and to encourage movements when the train has stopped inappropriately. The use of guided imagery techniques may be helpful to encourage your colon to find a more comfortable and regular pace. Relaxation exercises and gut-directed hypnotherapy may also help to encourage your large intestine to function in a more relaxed and less spastic manner.

Aim for Regularity

One way that might help to keep your digestive system humming along more smoothly is to try your best to keep your body on a regular routine. This means to make sure to establish regular sleep habits and to make sure to eat your meals at predictable times throughout your day. Many people who suffer from IBS skip meals in an attempt to avoid triggering symptoms. In my opinion, that is a mistake. It is better to eat small meals frequently throughout your day to keep the train rolling, so to speak. Your digestive system is continually creating stool -- by giving it regular food throughout the day you are helping to encourage the production of firm, well-formed stool matter, stool that will be easier for your intestines to process smoothly.

Use Bowel Retraining

Although bowel retraining is typically recommended for constipation, it can be of great use for those who suffer from IBS-A. Remember your goal is to help your body to get to the point where your bowels empty on a regular basis. Setting up a relaxed and routine time to sit on the toilet can perhaps help your body to re-connect with dormant bio-rhythms. If you are experiencing diarrhea, of course you will naturally be on the toilet, but you can take note of what time of day your diarrhea attacks are likely to happen and perhaps use this information when you are in a constipated state. When in a constipated stage, use this awareness regarding the time of day when your body might be most open to a bowel movement. At this time be sure to eat a larger meal, drink a hot drink, and perhaps take in some caffeine, all of which can help to prompt your bowels to empty. (Read more about bowel retraining…)

Think Calm, Not Empty

When dealing with diarrhea, many people think that it is necessary to empty the bowels fully in order to reduce the possibility of further attacks. This again, in my opinion, is a mistake. Remember my analogy of a freight train. A freight train that is unevenly weighted will not travel so smoothly. As you may notice when having a diarrhea episode, your first stool is likely to be more firmly formed. With each successive wave of diarrhea, the stool becomes more loose and watery. This is because the bowels are now emptying stool matter from high up within the intestines -- stool that has not yet had the opportunity for water to be drawn out of. The looser the stool, the harder it is for the intestines to hold it in place.

Therefore, whenever possible, after the initial one or two trips to the toilet, it would be helpful for you to try to encourage your body to hold on to the stool, rather than think that it is important to empty. Sit calmly and use your relaxation exercises to help calm your body and see if the urge to empty begins to pass. If urgency continues to rise, then by all means, make your way to the toilet. However, with practice you may find that you are able to resist those successive waves of diarrhea, leaving stool in place to form for tomorrow's bowel movement. (Read more about using relaxation to calm the body…)

Slowly Increase Fiber

IBS sufferers are often very wary of fiber. Adding too much fiber too soon may result in an increase in abdominal gas and bloating and subsequent abdominal pain. However, fiber is very important for healthy bowel functioning. Fiber is what fills up all the cars in your intestinal freight train, helping to encourage it to run more smoothly. The trick appears to be to increase your dietary fiber intake slowly. Any increased symptoms of gas and bloating might be eased with the addition of a probiotic. (Read more about increasing fiber…)

Try a Supplement

Although some herbal supplements are thought to target either the symptom of diarrhea or constipation, but not both, there are a couple of options that appear to be of use in easing IBS symptoms regardless of IBS sub-type. Remember to always check with your doctor before taking any over-the-counter herb or supplement.

  • Peppermint Oil:
    It is believed that peppermint oil has a relaxing effect on the smooth muscle that is responsible for intestinal contractions. Thus it may serve to reduce colon spasms, helping your system to operate in a more consistent manner. (Read more about peppermint oil…)
  • Slippery Elm
    Slippery elm is thought to be helpful for both constipation and diarrhea, making it a worthwhile option for potential relief of IBS-A. Slippery elm appears to gently coat the lining of the intestines, calming irritation. More importantly for our current discussion, slippery elm softens and softly bulks up the stool. This helpful effect on stool formation may make it easier for your intestines to find a more regular pace in terms of emptying. (Read more about slippery elm…)

DISCLAIMER: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.

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