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Gas, Bloating: Always Uncomfortable?

Medications Can Calm Spastic Colon


She presented her report this week at the annual meeting of the American College of Gastroenterology in Seattle.

Indeed, IBS is one of the most common intestinal disorders, and can be difficult to diagnose, says Gore. For many people, the symptoms alternate frequently. While gas and bloating are the constants, there may be abdominal pain or discomfort, plus altered bowel habits -- people may be constipated one week, have diarrhea the next, or have a sudden urge to have a bowel movement. The pattern varies from person to person, she says.

Experts don't know the exact cause of IBS, but suspect it may be triggered by stress, hormones, and nerve signal disruptions in the brain.

Many people with mild cases don't ever see a doctor for their problem. "There's much controversy about whether this is a real disease," Gore tells WebMD. "It's all about spastic colon. For some reason, in some people, the colon starts behaving erratically."

Prescription medications like Prilosec, Zantac, and Pepcid can "calm" the spasms that cause colon problems. Antidepressants seem to help control the pain, Gore adds. Pain, antidiarrheal, and anti-gas medications are available over the counter and there are two prescription therapies -- Lotronex and Zelnorm -- that may help some women with the disease.

But Gore's study found that these work for only one-third of gas-and-bloating sufferers. "Many more were saying that they weren't working," she tells WebMD.

Most people try to figure it all out on a trial-and-error basis, Gore adds. "Most patients alter their diets -- if they have constipation, they start eating a lot of fiber; if they have diarrhea they stop drinking coffee, stop eating beans."

For some people, it's a quality-of-life issue, she says. "Some people have been suffering for a year. Some don't 'go' for weeks at a time. Some have had to miss a lot of workdays. People are suffering. The pharmaceutical companies need to get products developed for these people."

The worst-case scenario: gas and bloating might signal colon cancer or inflammatory bowel disease, but people with those conditions usually also experience weight loss, blood in the stool, and anemia, adds Radhika Srinivasan, MD, a gastrointestinal specialist and assistant professor of medicine at the University of Pennsylvania in Philadelphia.

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Reviewed on October 22, 2002

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