Spastic colon is a former name for what doctors now call irritable bowel syndrome, or IBS. The original name refers to frequent, disorganized "spastic" contractions of the muscles in the colon that occur in response to a meal or other stimuli, such as stress. According to doctors at the Washington University School of Medicine, there is no cure for IBS, although treatments such as lifestyle change and medications can help control symptoms.
Diet Therapy
According to the Food and Nutrition Board of the National Institute of Medicine, Americans only consume about half of the recommended daily intake for dietary fiber. Gradual increases in dietary fiber from food sources such as whole grain breads and cereals, legumes, fruits and vegetables can help produce soft, formed regular bowel movements in people with IBS. The National Institutes of Health also recommend avoiding triggers such as large meals, dairy products, fatty foods, chocolate, caffeine, alcohol and carbonated beverages. For people who prefer not to give up certain foods, keeping a food diary that logs the foods an individual eats, symptoms the person experiences and times for each can provide information about individual triggers.
Antispasmodics
Taken 30 to 60 minutes before a meal, antispasmodics such as hyoscyamine, dicyclomine and belladonna-phenobarbital can reduce intestinal spasms that occur in response to a meal. In the 2008 edition of "Harrison's Principles of Internal Medicine," chief of gastroenterology for the University of Michigan Health System Dr. Chung Owyang explains that a meta-analysis of 26 clinical trials comparing antispasmodics to placebo medications showed modest benefits for antispasmodic-treated patients in terms of abdominal pain and global improvements. However, antispasmodics often cause unacceptable side effects such as dry mouth, urinary hesitation, urinary retention, sleepiness and blurred vision. In addition, older people and people with other health problems like liver, kidney or heart disease, glaucoma and gastroesophageal reflux disase can't take antispasmodics because they exacerbate these conditions.
Antidepressants
According to Charlene B. Dalton, P.A.C. and Douglas A. Drossman, M.D. of the University of North Carolina School of Medicine, antidepressants have emerged as drugs of interest in the treatment of IBS for reasons unrelated to their mood-elevating properties. Antidepressants appear to normalize abnormal reflex arcs between the colon and the spinal cord by silencing inappropriate pain signals from the colon. Tricyclic antidepressants appear to treat pain and improve diarrhea in patients with diarrhea-predominant IBS. People with constipation-predominant IBS do better with selective serotonin reuptake inhibitors, which appear to combat pain and increase the frequency of bowel movements in this group. A new group of antidepressants known as selective serotonin norepinephrine reuptake inhibitors shows promise, but as of August 2010 there's little evidence for its efficacy in either type of IBS.
References
- Washington University School of Medicine: Irritable Bowel Syndrome
- National Institutes of Health: What I need to know about Irritable Bowel Syndrome
- University of North Carolina School of Medicine: The Use of Antidepressants in the Treatment of Irritable Bowel Syndrome
- "Harrison's Principles of Internal Medicine, 19th edition;" A.S. Fauci et al. (eds); 2008
- "Dietary Reference Intakes"; United States Institute of Medicine -- Food and Nutrition Board; 2002
