P05.03. Integrative Primary Care Approach to Irritable Bowel Syndrome

Focus Area: Integrative Approaches to Care Irritable bowel syndrome (IBS) is thought to affect 5% to 10% of the population and is likely a constellation of disorders resulting in abdominal pain, diarrhea, and/or constipation. This presentation will review the scientific evidence for common integrative treatments. A comprehensive integrative history often elucidates underlying factors contributing to symptoms. Assessment of the foundations of health, as with most conditions, is important for IBS. In addition to nutrition, physical activity, sleep, stress management, and mental/spiritual health will be reviewed. There will be a specific mention of mind-body pain syndrome and its manifestations of abdominal pain. A review of available testing will discuss utility in pursuing laboratory confirmation of food allergy/intolerances. Dietary interventions address food intolerances and poor dietary choices. Elimination diets, including specific approaches such as the FODMAP diet, can result in dramatic symptom relief. Soluble fiber has been shown to be helpful; in contrast, adding insoluble fiber can exacerbate symptoms in some individuals. Probiotics have been studied widely and are recommended to help re-establish favorable gut flora. Strains, dosing, and duration will be addressed. Peppermint oil can address bloating. Other common supplements and botanicals for IBS will be reviewed. Treatments of stress reduction, cognitive behavioral therapy, and hypnosis have been evaluated for this condition and will be discussed.