Symptom Management

Symptom Management

Diarrhea and Constipation

The following are some ways of managing diarrhea, constipation, or both:

• To reduce mild to moderate diarrhea, take one teaspoon of psyllium hydrophilic colloid (Metamucil) twice a day in a glass of water.
• Anti-diarrhea drugs, such as loperamide (Imodium) and atropine/diphenoxylate (Lomotil), may help. In very ill patients, large doses of some drugs, such as Lomotil, can trigger the onset of toxic megacolon.
• Opiates or drugs used to relax muscle spasms may help relieve mild to moderate diarrhea and abdominal cramps, but they should be used for very short periods and not for severe cases.
• Bulk-type laxatives can help constipation.

Treating Anemia

Iron supplements may be required for anemia. Intravenous (IV) iron with or without erythropoietin (a hormone that acts in the bone marrow to increase the production of red blood cells) is effective for severe anemia in IBD that does not respond to iron alone. Crohn's disease patients benefit from the combination. Patients with ulcerative colitis usually improve on IV iron alone.

Antidepressants

Antidepressants may help relieve emotional problems. However, inflammatory bowel disease is not a psychological disorder, and such drugs will not affect the basic illness.

Pain-Relievers

Acetaminophen (Tylenol) is the drug of choice for mild pain. Acetaminophen is not a nonsteroidal anti-inflammatory drugs (NSAIDs), which include, among dozens of others, aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), and the Cox-2 inhibitor celecoxib (Celebrex). NSAIDs have been thought to cause symptom flare-ups in patients with IBD. However, a comprehensive 2006 study concluded that these drugs are as safe for patients with IBD as for other patients, and that they can help prevent relapse as well as provide short-term pain relief. You should talk to your doctor about whether NSAIDs are right for you.

Stress Reduction

Although stress is not a cause of inflammatory bowel disease, there are reports of an association between stress and symptom flare-ups. Patients with IBD, in fact, may have a more exaggerated physical response to stressful events than people without IBD. Although no evidence exists to confirm that stress reduction techniques, such as relaxation methods, meditation, or cognitive therapy, manage the disease, they might be helpful.

Alternative Remedies

Castor Oil Pack. Some people report relief from the use of a castor oil pack for 3 consecutive days. The oil is applied directly to the skin and then covered with a clean soft cloth and plastic wrap. A hot water bottle or heating pad is then placed over the pack for 30 - 60 minutes.

Acupuncture. Acupuncture may help relieve symptoms in some patients.