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<<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