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afya
IBS Mx
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> Difficult and variable - relate to predominant Sx ''1st line'' Pain - antispasmodic Constipation - laxatives but avoid lactulose Diarrhoea - Loperamide ''2nd line'' low dose antidepressants (amitryptiline 5-10mg, then SSRI) ''Other'' Psychological esp if refractory (not responding to 1st line) - CBT, hypnotherapy,... CAM - don't encourage acupuncture or reflexology ''General'' Regular meals with time to eat avoid missing meals / long gaps between eating drink 8+ cups fluid / day esp water or non-caffeine drinks tea/coffee - restrict to 3/day reduce alcohol / fizzy drink intake ?limit intake of fibre rich food and "resistant starch" found in processed food (bran, wholemeal flour or brown rice) fresh fruit - only 3/day avoid sorbitol if diarrhoea wind / bloating consider oats and linseed
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