Frequently Asked Questions
Yes. This is a very safe and highly effective treatment for diarrhoea but the cause of the diarrhoea should be investigated before starting long term treatment
The commonest indication is for diarrhoea-predominant irritable bowel syndrome where there is urgency of bowel habit and fear of incontinence. One or two capsules of loperamide daily can significantly improve quality of life. Sometimes in IBS there is sensitivity to the action of loperamide and only small doses are required. In this situation the tablet needs to be prescribed so that only half tablet can be taken daily
There is some recent interest in breath tests to evaluate IBS. These are breath hydrogen tests after a meal of fructose, lactose and lactulose. Each sugar needs to be tested separately and the test takes 2-3 hours for each sugar. Often just the fructose test is performed. The concept is that response to a FODMAP diet can be predicted by a positive fructose breath test - i.e showing failure of normal absoprtion of fructose (malabsorption). In practice a positive test is very common and has minimal predictive value.
Positive breath tests for lactose may be found in 10-15% of people with IBS and 5% of the general population. Knowledge of a positive test can be helpful although a trial of diary exclusion for a month is perhaps more informative as symptoms from diary products may be due to factors other than the lactose.
Some groups have proposed that bacterial overgrowth in the small bowel causes many of the symptoms of IBS particularly bloating. Tests for this possible abnormality are difficult. A simple test is the lactulose breath test but this is difficult to interpret. There is a relatively high rate of positive tests making it difficult to know if this is a genuine finding. There is an antibiotic called rifaxamin that is claimed to treat this problem. This antibiotic is expensive and has limited availability and is not used in NZ for IBS. There may be some people who will benefit from this treatment if cheaper alternatives are available. it is not clear if repeated courses - perhaps every 3 months - will continue to maintain the improvement in symptoms.
Some tests also check for methane as well as H2 (hydrogen). About 40% of people are methane producers and this will give some extra information. Methane actually slows down the bowel - ? cause or effect. There is debate as to what to do with a positive test (as applies for hydrogen tests)
Yes, natural treatments will always be the best approach (compared to medication) for a condition that may continue for some time
Probiotics are useful. I recommend Inner Health Plus or IBS Support (Ethical Nutrients).
Aloe vera juice is useful to relieve spasm pains and has a mild laxative effect
If there is constipation then kiwifruit concentrates such as Kiwi Crush may help
The best option is careful dietary exclusion. See page on Diet and IBS
NO. There is no evidence that dietary restrictions of any sort will prevent progression of the disease or prevent complications such as infection or bleeding
Prebiotics are currently being promoted for gut health and IBS. They are poorly absorbed carbohyrates - e.g short chains of fructose or resistant starch. They are fermented by colonic bacteria. The breakdown products result in substrate (food) for the colon and also encourage the growth of "good" bacteria such as Lactobacillus.
These beneficial effects have theoretical value but remain unproven in IBS. The major disadvantage is the increase in bloating and flatulence - often troublesome symptoms in IBS
This natural product has a long history of use in treating bowel problems. There is some anti-spasmodic effect and a mild laxative effect. This can be useful for some people with IBS
Yes. This is a very safe and highly effective treatment for diarrhoea but the cause of the diarrhoea should be investigated before starting long term treatment
The commonest indication is for diarrhoea-predominant irritable bowel syndrome where there is urgency of bowel habit and fear of incontinence. One or two capsules of loperamide daily can significantly improve quality of life. Sometimes in IBS there is sensitivity to the action of loperamide and only small doses are required. In this situation the tablet needs to be prescribed so that only half tablet can be taken daily
There is some recent interest in breath tests to evaluate IBS. These are breath hydrogen tests after a meal of fructose, lactose and lactulose. Each sugar needs to be tested separately and the test takes 2-3 hours for each sugar. Often just the fructose test is performed. The concept is that response to a FODMAP diet can be predicted by a positive fructose breath test - i.e showing failure of normal absoprtion of fructose (malabsorption). In practice a positive test is very common and has minimal predictive value.
Positive breath tests for lactose may be found in 10-15% of people with IBS and 5% of the general population. Knowledge of a positive test can be helpful although a trial of diary exclusion for a month is perhaps more informative as symptoms from diary products may be due to factors other than the lactose.
Some groups have proposed that bacterial overgrowth in the small bowel causes many of the symptoms of IBS particularly bloating. Tests for this possible abnormality are difficult. A simple test is the lactulose breath test but this is difficult to interpret. There is a relatively high rate of positive tests making it difficult to know if this is a genuine finding. There is an antibiotic called rifaxamin that is claimed to treat this problem. This antibiotic is expensive and has limited availability and is not used in NZ for IBS. There may be some people who will benefit from this treatment if cheaper alternatives are available. it is not clear if repeated courses - perhaps every 3 months - will continue to maintain the improvement in symptoms.
Some tests also check for methane as well as H2 (hydrogen). About 40% of people are methane producers and this will give some extra information. Methane actually slows down the bowel - ? cause or effect. There is debate as to what to do with a positive test (as applies for hydrogen tests)
Yes, natural treatments will always be the best approach (compared to medication) for a condition that may continue for some time
Probiotics are useful. I recommend Inner Health Plus or IBS Support (Ethical Nutrients).
Aloe vera juice is useful to relieve spasm pains and has a mild laxative effect
If there is constipation then kiwifruit concentrates such as Kiwi Crush may help
The best option is careful dietary exclusion. See page on Diet and IBS
NO. There is no evidence that dietary restrictions of any sort will prevent progression of the disease or prevent complications such as infection or bleeding
Prebiotics are currently being promoted for gut health and IBS. They are poorly absorbed carbohyrates - e.g short chains of fructose or resistant starch. They are fermented by colonic bacteria. The breakdown products result in substrate (food) for the colon and also encourage the growth of "good" bacteria such as Lactobacillus.
These beneficial effects have theoretical value but remain unproven in IBS. The major disadvantage is the increase in bloating and flatulence - often troublesome symptoms in IBS
This natural product has a long history of use in treating bowel problems. There is some anti-spasmodic effect and a mild laxative effect. This can be useful for some people with IBS
Yes. This is a very safe and highly effective treatment for diarrhoea but the cause of the diarrhoea should be investigated before starting long term treatment
The commonest indication is for diarrhoea-predominant irritable bowel syndrome where there is urgency of bowel habit and fear of incontinence. One or two capsules of loperamide daily can significantly improve quality of life. Sometimes in IBS there is sensitivity to the action of loperamide and only small doses are required. In this situation the tablet needs to be prescribed so that only half tablet can be taken daily
There is some recent interest in breath tests to evaluate IBS. These are breath hydrogen tests after a meal of fructose, lactose and lactulose. Each sugar needs to be tested separately and the test takes 2-3 hours for each sugar. Often just the fructose test is performed. The concept is that response to a FODMAP diet can be predicted by a positive fructose breath test - i.e showing failure of normal absoprtion of fructose (malabsorption). In practice a positive test is very common and has minimal predictive value.
Positive breath tests for lactose may be found in 10-15% of people with IBS and 5% of the general population. Knowledge of a positive test can be helpful although a trial of diary exclusion for a month is perhaps more informative as symptoms from diary products may be due to factors other than the lactose.
Some groups have proposed that bacterial overgrowth in the small bowel causes many of the symptoms of IBS particularly bloating. Tests for this possible abnormality are difficult. A simple test is the lactulose breath test but this is difficult to interpret. There is a relatively high rate of positive tests making it difficult to know if this is a genuine finding. There is an antibiotic called rifaxamin that is claimed to treat this problem. This antibiotic is expensive and has limited availability and is not used in NZ for IBS. There may be some people who will benefit from this treatment if cheaper alternatives are available. it is not clear if repeated courses - perhaps every 3 months - will continue to maintain the improvement in symptoms.
Some tests also check for methane as well as H2 (hydrogen). About 40% of people are methane producers and this will give some extra information. Methane actually slows down the bowel - ? cause or effect. There is debate as to what to do with a positive test (as applies for hydrogen tests)
Yes, natural treatments will always be the best approach (compared to medication) for a condition that may continue for some time
Probiotics are useful. I recommend Inner Health Plus or IBS Support (Ethical Nutrients).
Aloe vera juice is useful to relieve spasm pains and has a mild laxative effect
If there is constipation then kiwifruit concentrates such as Kiwi Crush may help
The best option is careful dietary exclusion. See page on Diet and IBS
NO. There is no evidence that dietary restrictions of any sort will prevent progression of the disease or prevent complications such as infection or bleeding
Prebiotics are currently being promoted for gut health and IBS. They are poorly absorbed carbohyrates - e.g short chains of fructose or resistant starch. They are fermented by colonic bacteria. The breakdown products result in substrate (food) for the colon and also encourage the growth of "good" bacteria such as Lactobacillus.
These beneficial effects have theoretical value but remain unproven in IBS. The major disadvantage is the increase in bloating and flatulence - often troublesome symptoms in IBS
This natural product has a long history of use in treating bowel problems. There is some anti-spasmodic effect and a mild laxative effect. This can be useful for some people with IBS
Yes. This is a very safe and highly effective treatment for diarrhoea but the cause of the diarrhoea should be investigated before starting long term treatment
The commonest indication is for diarrhoea-predominant irritable bowel syndrome where there is urgency of bowel habit and fear of incontinence. One or two capsules of loperamide daily can significantly improve quality of life. Sometimes in IBS there is sensitivity to the action of loperamide and only small doses are required. In this situation the tablet needs to be prescribed so that only half tablet can be taken daily
There is some recent interest in breath tests to evaluate IBS. These are breath hydrogen tests after a meal of fructose, lactose and lactulose. Each sugar needs to be tested separately and the test takes 2-3 hours for each sugar. Often just the fructose test is performed. The concept is that response to a FODMAP diet can be predicted by a positive fructose breath test - i.e showing failure of normal absoprtion of fructose (malabsorption). In practice a positive test is very common and has minimal predictive value.
Positive breath tests for lactose may be found in 10-15% of people with IBS and 5% of the general population. Knowledge of a positive test can be helpful although a trial of diary exclusion for a month is perhaps more informative as symptoms from diary products may be due to factors other than the lactose.
Some groups have proposed that bacterial overgrowth in the small bowel causes many of the symptoms of IBS particularly bloating. Tests for this possible abnormality are difficult. A simple test is the lactulose breath test but this is difficult to interpret. There is a relatively high rate of positive tests making it difficult to know if this is a genuine finding. There is an antibiotic called rifaxamin that is claimed to treat this problem. This antibiotic is expensive and has limited availability and is not used in NZ for IBS. There may be some people who will benefit from this treatment if cheaper alternatives are available. it is not clear if repeated courses - perhaps every 3 months - will continue to maintain the improvement in symptoms.
Some tests also check for methane as well as H2 (hydrogen). About 40% of people are methane producers and this will give some extra information. Methane actually slows down the bowel - ? cause or effect. There is debate as to what to do with a positive test (as applies for hydrogen tests)
Yes, natural treatments will always be the best approach (compared to medication) for a condition that may continue for some time
Probiotics are useful. I recommend Inner Health Plus or IBS Support (Ethical Nutrients).
Aloe vera juice is useful to relieve spasm pains and has a mild laxative effect
If there is constipation then kiwifruit concentrates such as Kiwi Crush may help
The best option is careful dietary exclusion. See page on Diet and IBS
NO. There is no evidence that dietary restrictions of any sort will prevent progression of the disease or prevent complications such as infection or bleeding
Prebiotics are currently being promoted for gut health and IBS. They are poorly absorbed carbohyrates - e.g short chains of fructose or resistant starch. They are fermented by colonic bacteria. The breakdown products result in substrate (food) for the colon and also encourage the growth of "good" bacteria such as Lactobacillus.
These beneficial effects have theoretical value but remain unproven in IBS. The major disadvantage is the increase in bloating and flatulence - often troublesome symptoms in IBS
This natural product has a long history of use in treating bowel problems. There is some anti-spasmodic effect and a mild laxative effect. This can be useful for some people with IBS