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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2015; 21(40): 11379-11386
Published online Oct 28, 2015. doi: 10.3748/wjg.v21.i40.11379
Published online Oct 28, 2015. doi: 10.3748/wjg.v21.i40.11379
Food, fibre, bile acids and the pelvic floor: An integrated low risk low cost approach to managing irritable bowel syndrome
Hamish Philpott, Sanjay Nandurkar, John Lubel, Peter R Gibson, Monash University, Eastern Health, The Alfred Hospital, Melbourne 3128, Australia
Author contributions: Philpott H proposed, conceptualised, researched and wrote the paper; Nandurkar S researched and suggested modifications; Lubel J edited the paper; Gibson PR provided previous literature and concepts related to dietary treatment.
Conflict-of-interest statement: The authors have no conflict of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Hamish Philpott, Department of Gastroenterology, Eastern Health, 5 Arnold St., Box Hill, Melbourne 3128, Australia. hamish.philpott@monash.edu
Telephone: +61-3-90766000
Received: April 30, 2015
Peer-review started: May 8, 2015
First decision: July 14, 2015
Revised: August 21, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: October 28, 2015
Processing time: 175 Days and 17.9 Hours
Peer-review started: May 8, 2015
First decision: July 14, 2015
Revised: August 21, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: October 28, 2015
Processing time: 175 Days and 17.9 Hours
Abstract
Patients presenting with abdominal pain and diarrhea are often labelled as suffering from irritable bowel syndrome, and medications may be used often without success. Advances in the understanding of the causes of the symptoms (including pelvic floor weakness and incontinence, bile salt malabsorption and food intolerance) mean that effective, safe and well tolerated treatments are now available.
Keywords: Bile acids; Pelvic floor; Food intolerance; Irritable bowel syndrome; Diarrhoea
Core tip: Decreasing the dietary intake of poorly absorbed carbohydrates and/or using bile acid binders can greatly decrease symptoms of diarrhoea. Pelvic floor weakness with urgency and incontinence may masquerade as diarrhoea and can be managed with soluble fibre supplements and bile acid binders in many cases.