How to Manage Your Symptoms of IBS-A

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Treatment of alternating type irritable bowel syndrome (IBS-A) can be challenging. This is due to the fact that bowel symptoms swing from diarrhea to constipation and back again. It is a common concern that steps taken to address one symptom will result in bringing on the unwanted effects of the other.

Further contributing to the problem is the fact that there is scant research focused directly on this "mixed-type" IBS. However, there may be steps that you can take to more comfortably manage your unpredictable and erratic intestinal system.

Instead of IBS-A, the current Rome IV criteria changed to using the term "IBS with mixed bowel habits" (IBS-M). 

The following suggestions are not research-supported but are offered to serve as a possible guide to dealing with the frustrations of IBS-A (IBS-M).

Visualize a Functioning System

It is helpful to picture your intestinal system as a long freight train. With IBS-A, the train is careening out of control at times and then stopped short at other times. Your goal is to do whatever is possible to encourage your system to move along at a regular pace, with periodic station stops. This means taking steps to calm the system when it is too agitated (diarrhea) and encouraging movements when the train has stopped inappropriately (constipation).

The use of guided imagery techniques may be helpful to encourage your colon to find a more comfortable and regular pace. Relaxation exercises and gut-directed hypnotherapy may also help encourage your large intestine to function in a more relaxed and less spastic manner.

Aim for Regularity

One way that might help to keep your digestive system humming along more smoothly is to try your best to keep your body on a regular routine. This includes establishing regular sleep habits and eating your meals at predictable times throughout your day.

Many people who deal with IBS skip meals in an attempt to avoid triggering symptoms. It is better to eat small meals frequently throughout your day to keep the train rolling, so to speak.

Your digestive system is continually creating stool. By giving it regular food throughout the day you are encouraging the production of a firm, well-formed stool matter. This, in turn, will be easier for your intestines to process smoothly.

Use Bowel Retraining

Although bowel retraining is typically recommended for constipation, it can be of great use for those who suffer from IBS-A. Your goal is to help your body get to the point where your bowels empty on a regular basis. Setting up a relaxed and routine time to sit on the toilet can perhaps help your body to reconnect with dormant bio-rhythms.

If you are experiencing diarrhea, you will naturally be on the toilet. You can take note of the time of day when your diarrhea attacks are likely to happen. This information may be useful when you are in a constipated state.

When in a constipated stage, use that awareness to know when your body might be most open to a bowel movement. At this time, try to eat a larger meal, drink a hot drink, and perhaps take in some caffeine. All of these can help prompt your bowels to empty.

Think Calm, Not Empty

When dealing with diarrhea, many people think that it is necessary to empty the bowels fully in order to reduce the possibility of further attacks. This might not be so because, back to our analogy, a freight train that is unevenly weighted will not travel as smoothly.

As you may have noticed when having a diarrhea episode, your first stool is likely to be more firmly formed. With each successive wave of diarrhea, the stool becomes more loose and watery. This is because the bowels are now emptying stool matter from high up within the intestines. This stool has not yet had the opportunity for water to be drawn out of it. The looser the stool, the harder it is for the intestines to hold it in place.

Therefore, whenever possible, after the initial one or two trips to the toilet, it would be helpful to try and encourage your body to hold onto the stool, rather than think that it is important to empty. Sit calmly and use your relaxation exercises to help calm your body and see if the urge to empty begins to pass. If urgency continues to rise then, by all means, make your way to the toilet.

With practice, you may find that you are able to resist those successive waves of diarrhea. This leaves stool in place to form for tomorrow's bowel movement.

Slowly Increase Fiber

People dealing with IBS are often very wary of fiber. Adding too much fiber too soon may result in an increase in abdominal gas and bloating and subsequent abdominal pain. However, fiber is very important for healthy bowel functioning.

Fiber is what fills up all the cars in your intestinal freight train, helping to encourage it to run more smoothly. The trick appears to be to increase your dietary fiber intake slowly. Any increased symptoms of gas and bloating might be eased with the addition of a probiotic. 

Try a Supplement

Some herbal supplements are thought to target either the symptom of diarrhea or constipation, but not both. There are a couple of options that appear to be of use in easing IBS symptoms regardless of the IBS sub-type. Remember to always check with your doctor before taking any over-the-counter herb or supplement.

  • Peppermint Oil - It is believed that peppermint oil has a relaxing effect on the smooth muscle that is responsible for intestinal contractions. Thus it may serve to reduce colon spasms and help your system to operate in a more consistent manner.
  • Slippery Elm - Slippery elm is thought to be helpful for both constipation and diarrhea, making it a worthwhile option for potential relief of IBS-A. Slippery elm appears to gently coat the lining of the intestines, calming irritation. More importantly for our current discussion, slippery elm softens and softly bulks up the stool. This helpful effect on stool formation may make it easier for your intestines to find a more regular pace for emptying. 
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