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MYTH: All patients with irritable bowel syndrome (IBS) exhibit a similar cluster of symptoms, including abdominal pain, bloating, and chronic diarrhea.
FACT: A patient with IBS may have only one or two of these three predominant symptoms: constipation, diarrhea, or pain with gas and bloating.
MYTH: Irritable bowel syndrome can lead to inflammatory bowel disease (IBD) or colon cancer.
FACT: Although IBS is a chronic condition, it's a functional disorder and doesn't progress to more serious problems such as IBD or colon cancer. Symptoms may never be completely resolved, but can be managed by identifying symptom triggers and by taking medications.
MYTH: Emotional stress is the leading cause of IBS.
FACT: The cause of IBS is unknown, but, in many patients, stress triggers symptoms. For these patients, identifying the psychosocial stressor and using techniques such as relaxation therapy, stress management, hypnosis, and cognitive behavior therapy may help reduce abdominal pain and diarrhea.
MYTH: A simple treatment plan is available to patients suffering from IBS.
FACT: Because IBS symptoms vary among patients, no standard protocol has been developed. Therapy typically focuses on the patient's predominant symptom. A patient with constipation-predominant IBS may benefit from increasing dietary fiber intake, although someone with diarrhea-predominant IBS may need antidiarrheal agents such as loperamide and an antispasmodic drug to manage abdominal pain.
MYTH: Antidiarrheals and antispasmodics are the only medications given for diarrhea-predominant IBS.
FACT: Other promising treatments for diarrhea-predominant IBS include benzodiazepines, 5-HT3 antagonists, antibiotics, and antidepressants.
MYTH: All patients with IBS must strictly adhere to a specific diet for symptom management.
FACT: A specific IBS diet doesn't exist, but some patients must avoid certain foods that trigger symptoms. Keeping a food and symptom diary can help them identify trigger foods. Various existing diets as well as elimination diets haven't proven effective in managing symptoms of IBS, and the American Gastroenterological Association warns against unnecessarily restrictive diets. Most patients benefit from limiting or avoiding alcohol, caffeine, high-fat foods, excess fruit, sorbitol, and gas-producing vegetables, which all may aggravate IBS symptoms.
American Gastroenterological Association medical position statement: Irritable bowel syndrome. Gastroenterology. 123(6):2105-2107, December 2002.
Andresen V, Camilleri M. Irritable bowel syndrome: Recent and novel therapeutic approaches. Drugs. 66(8):1073-1088, 2006.
Hadley SK, Gaarder SM. Treatment of irritable bowel syndrome. American Family Physician. 72(12):2501-2506, December 15, 2005.
Horwitz BJ, Fisher RS. The irritable bowel syndrome. The New England Journal of Medicine. 334(24):1846-1850, June 14, 2001.
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