Irritable Bowel Syndrome
Background
Spastic colon, also called Irritable Bowel Syndrome, is when you have gas, bloating, diarrhea and/or constipation with a negative medical workup. When doctors do not know what is causing your symptoms, we give it the label "spastic colon," instead of more effectively searching for the source of your symptoms.
The most effective way to eliminate spastic colon is to treat the underlying causes. This condition is sometimes caused by food sensitivity such as to lactose in milk or fructose in sodas. More often, however, it is caused by an infection, and most patients’ spastic colon resolves when the underlying bacterial, fungal and parasitic bowel infections are treated. Unfortunately, there is no reliable test for fungal overgrowth, which is why this is missed. Suspect yeast overgrowth if you also have chronic sinusitis or nasal congestion. These also often go away when the fungal infection is treated — along with the spastic colon.
Small intestinal bacterial overgrowth (called SIBO) can also mimic spastic colon and responds to the same treatments along with treating low thyroid issues (even if blood testing is normal). SIBO, as well as lactose and fructose intolerance, can be diagnosed by Hydrogen Breath Testing (HBT), though these are usually not needed.
Treatments
General Diet Advice
Stop milk and fructose
Stop milk and fructose (i.e., sodas) for 10 days. If symptoms resolve off these, stop sodas (diet sodas are OK) and try lactose free milk products. With lactose intolerance, most people can have some milk. They just don’t have the enzymes to digest more than a certain amount, and then it causes gas (not dangerous — just a nuisance). Taking the missing enzyme by mouth (called lactase — found in products such as LactAid may allow you to tolerate more dairy products. I also avoid excess sweets.
Recommended Supplements
Magnesium
If constipation is a predominant symptom, increase fiber and water, and take 200-300 mg of magnesium a day.
Other Therapies & Advice
If you have constipation
If you have symptoms of it, see Constipation.
Check for candida
See Candida for fungal/yeast treatment.
Check for and treat parasites
Do stool testing for parasites only at a lab that specializes in this (e.g., Genova Labs by mail, see www.genovadiagnostics.com).
Take an enteric-coated probiotic to support healthy bowel function
If not enteric coated, your stomach acid will simply kill the healthy bacteria. I recommend beginning with a high-potency probiotic (50 billion bacteria) 1 a day for 1 month followed by a probiotic pearl 1 a day.
Check for SIBO
If symptoms persist, especially if your flatus has a rotten egg smell (think "silent but deadly"), ask your doctor to do a Hydrogen Breath Test (HBT) to look for Small Intestinal Bacterial Overgrowth, or "SIBO" (bacterial overgrowth). If the HBT shows SIBO/infections, or for persistent severe IBS, I suggest using the antibiotic Rifaximin (Xifaxin) 550 mg/day for 7-14 days and also treat for an underactive thyroid (see Hypothyroidism), a main cause of SIBO. This antibiotic is expensive, so if not covered by insurance, I will sometimes instead use Neomycin 500 mg by mouth 4x day for 10 days. For spastic colon with diarrhea, combining neomycin and Rifaximin can be most effective.
Berberine
Take berberine 500 mg 3x a day.
Look for and treat food allergies
If the SIBO tests are negative, treat for food allergies using an acupressure technique by NAET (see www.NAET.com).
Peppermint oil caps
For gas pains, begin with enteric-coated peppermint oil caps (e.g., Peppermint Plus by Enzymatic Therapy), which eases the cramps.
Mylicon
For bloating, chew over the counter Mylicon (simethicone) tablets.
More Information Online
Small Intestinal Bacterial Overgrowth (SIBO)
NAET (acupressure technique for treating food allergies at www.NAET.com)