Ask the Pharmacist

Q: I have heard that there is a new and natural way to treat Irritable Bowel Syndrome (IBS). What can you tell me about it?

A: IBgard first became available in Canada last fall but its principal ingredient, oil of peppermint, has been available and used for decades.

What makes IBgard different than just purchasing a bottle of liquefied oil of peppermint (which has been readily available for some time now) is that the active ingredient is contained within enteric-coated capsules which prevents the oil from breaking down in the stomach and instead delivers the drug to the intestines where the heart of the problem with IBS lies.

In this way, IBgard mimics a drug called Colpermin which disappeared from the market more than a decade ago but provided effective and safe relief to the many who relied on it.

IBS is a relatively-common disorder of the gastrointestinal tract that is characterized by chronic intermittent symptoms, such as bloating/swelling of your stomach, abdominal discomfort, cramps, excessive gas, the appearance of whitish mucus in the stool, the feeling that your bowel movement is not finished after going to the toilet, and altered bowel movements that can be either predominantly diarrhea, constipation or both.

Less-commonly, people with IBS may also have to deal with a feeling of fatigue or sickness, backache, assorted bladder problems, incontinence and pain during sex.

While the cause of IBS is unknown, it appears that the heart of the problem lies with a breakdown in the communications between the brain and the nerves and muscles of the intestinal tract. This seems to cause them to be extra-sensitive to normal sensations, resulting in pain and abnormal digestion of food.

Treatment has traditionally been aimed at managing the symptoms through changes in your lifestyle or diet. These include avoiding foods that trigger attacks (commonly fatty foods, caffeine, alcohol, and if your symptoms are mainly diarrhea, limiting dairy products and artificial sweeteners), minimizing your consumption of foods that tend to produce lots of gas (beans, cabbage, uncooked broccoli), consuming more fibre in your diet (this should be done in a gradual fashion so as to minimize the potential for temporary worsening of your symptoms as your body abruptly adjusts), increasing your exercise and learning to control your stress (which seems to be a very common trigger for flare-ups of symptoms).

There are also various prescription and over-the-counter medications that can help lessen the spasms or normalize your bowel movements.

While these changes and medications have helped many patients regain control, there are many others whose ongoing symptoms have deteriorated their quality of life. Enter IBgard, which based on a four-week study conducted in the United States, may help meet the needs of these people.

The study involved 72 people (75 per cent female), aged 18-60 (with an average age of 40 years) whose symptoms were either diarrhea predominant or cycled back and forth between loose bowel movements and constipation.

In order to qualify for the study, each participant had to have been suffering from persistent abdominal pain of great than four on a one-to-10 scale, and meet other indicators proving that they had more than a mild case. The individuals then unknowingly received either a placebo or six capsules of IBgard per day.

The recipients of the IBgard noted an 18.8-per-cent improvement of their symptoms within 24 hours of starting the therapy and this number climbed to 39.6 per cent by the end of the four weeks. As well, there was an immediate reduction in those reporting severe symptoms (30 per cent less within 24 hours) and this relief seemed to persist throughout the four weeks as there was a 66-per-cent reduction at that point.

In fact, IBgard seemed to reduce both the frequency and the intensity of all eight of the measured symptoms of IBS - abdominal pain, bloating, diarrhea, constipation, feeling of incomplete evacuation, urgency, pain at evacuation, and gas or mucus. Also, side effects seem to be at placebo-type levels, indicating that, as one would expect, long-term safety is not likely to be an issue.

At the conclusion of the study, 88.3 per cent of patients noted moderate to major improvements in their symptoms or quality of life, and the same number indicated they were likely to continue taking IBgard on an ongoing basis.

There have been other studies in the past using assorted preparations of peppermint which seem to support these findings although in truth there have been other studies with conflicting results. It is believed that peppermint acts as an antispasmodic thus reducing the contractions of the smooth muscles that surround our small intestine. This all seems positive given its efficacy, its quick onset of action and the fact that most people like taking products that are considered natural.

The downsides are that IBgard is not appropriate for those with IBS in which constipation is the predominant symptoms, and the fact that it can be expensive. A box of 24 retails at our pharmacy for $24.99 (plus tax, of course) and the dose needed can vary – from one capsule all the way up to eight capsules per day.

At the higher end of that usage, this treatment can certainly add up and while it appears that because of its quick action some will be able to come on and off this drug as needed, it is not a cure, so it will need to be taken at least, periodically, on an ongoing basis.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts