- Definition and description of the irritable bowel syndrome.
Description of current conventional and medical treatment.
- Discuss and critically assess the alternative medical therapies proposed to treat the condition.
- Suggestions on how conventional and alternative medical therapies could be blended.
Risks or benefits.
- Assessment of the risks or benefits of combining conventional and alternative medical therapies.
Implications for nursing practice.
- Discussion of implications for nursing practice.
This document contains a discussion of irritable bowel syndrome in relation to how alternative medical therapies could blend with conventional medicine in successfully treating the condition. A critical assessment of how the proposed alternative medical therapies proposed treat the condition will be discussed. Also, suggestions of how conventional and alternative medical therapies could be blended will be given as well as benefits, risks and implication for medical practice will be explored before drawing conclusions.
Alternative medical therapies are a series of interventions, which have the ability to cure or relief a medical condition, but there is no scientific evidence to prove the validity of the remedy. Conventional medicine refers to the practice of medicine based on scientific evidence that interventions work (Grove et.al, 2001).
Definition and description of the irritable bowel syndrome.
Irritable bowel syndrome (IBS) is a medical disorder affecting the gastro intestinal system particularly the large intestine or colon. Characteristic signs and symptoms include abdominal pain accompanied by cramping, bloating gas, and diarrhea/constipation. Inspite of these signs and symptoms scientists do not regard irritable bowel syndrome as severely affecting the colon integrity. Women are twice more likely to have the disorder than men. Importantly, it costs the United States health care system approximately $1.7–$10 billion directly, $20 billion indirect and a total $21.7–$30 billion annually to treat irritable bowel syndrome (Hulisz, 2004).
This condition usually affects people over the 50 year old age group. Diagnosis can be made from symptoms alone, but besides the obvious ones mentioned earlier irritable bowel syndrome can also cause people to lose weight. It often occurs after an infection when the body’s immune system becomes compromised. A prevalence of protozoa infections in industrialized nations has been associated with irritable bowel syndrome incidences. Mexico has the highest prevalence rate. It stands at 46%; next is Brazil with 43%; United States of America has a14% rate and Canada has the lowest rate at 6% (Mayer, 2008).
Description of current conventional and medical treatment
There is no cure for the disease. However, treatment is symptomatic aimed at restoring emotional balance though patient education; dietary adjustments and medications. Due to frustrations some patients turn to alternative remedies for relief. Since people affected by irritable bowel syndrome encounter food intolerance diet becomes a major aspect of the management. Consequently, poorly absorbed carbohydrates are restricted from the diet particularly fructose and lactose are removed due to inadequate small intestines absorption (Mayer, 2008).
Soluble fiber supplements such as psyllium/ispagula husk has proven to be very successful through a meta-analysis study of the ingredient being added to diets of irritable bowel syndrome patients. It greatly relived symptoms helping them cope better with the disease. Regarding medication a combination of stool softeners and antidiarrheal medication have been used to relive constipation and diarrhea respectively. When dietary fibers are not tolerated osmotic laxatives like glycol, lactulose and sorbitol are used to prevent cathartic colon, a common complication of irritable bowel syndrome (Mayer, 2008).
Gastrointestinal agents such as Lubiprostone are used to treat idiopathic chronic constipation. Studies have been conducted to prove its efficacy in adults, but its application in children has been cautious. However, the drug does not show any electrolyte imbalance side effects as other laxatives do. Antispasmodics are another group of drugs adapted in contemporary conventional therapies in the treatment of this disorder. Neurotropics and musculotropics are the two most commonly groups of antispasmodics applied to treatment of irritable bowel syndrome, especially when patients are likely to experience severe cramps (Grove et.al, 2005).
Tricyclic antidepressants; serotonin agonists and serotonin antagonists are among the other drug combinations applied in the treatment of irritable bowel syndrome. Non pharmacological therapies include exercise; small bowel bacterial overgrowth therapy because 80% of patients with irritable bowel syndrome have small bowel over growth too. Psychotherapy offered heartening solutions being tested overtime for efficacy ((Mayer, 2008).
A survey conducted in 2006 applying the questionnaire instrument seeking both patients’ and health care providers’ perspectives of the disease revealed that knowledge regarding foods to avoid was paramount among 60% of respondents; etiology of the diseases claimed 55% of respondents’ attention; medications which can help was 58% of respondent’s interest. Fifty six percent (56%) wanted to know more about coping strategies. Learning about psychological factors influencing irritable bowel syndrome was the desire of 55% of the sample. Eighty percent (80%) of patients’ wanted their physicians to be more accessible though telephone conversations; email messaging. Options regarding physicians’ willingness to listen to concerns were expressed by (80%). Seventy three (73% ) looked forward to therapies, which provide hope and 63% needed more support in coping with the disease than which was presently available through medical science interventions (Ducrotté, 2007).
Alternative treatment. Discuss and critically assess the alternative medical therapies proposed to treat the condition.
Due to failure of conventional medicine in successfully treating irritable bowel syndrome many patients have resorted to alternative medicine. More importantly, it would appear that in many incurable diseases the psychological criterion is of value in its resolution. Hence, this might be the background to medical treatment being ineffective in 50% of cases. Alternatively, probiotics have been used with great success being administered at a rate between 10 to 100 billion beneficial bacteria per day. Research is still being done in determining the bacterial strains which are involved. Herbal remedies include peppermint oil; cannabis; Kiwi fruit; commiphora mukul and plantago ovata (Rahimi et.al, 2010). A study conducted in 2004 in UK, using aloe vera herb revealed that aloe vera gel was effective in treating irritable bowel syndrome. Researchers fed patients twice daily with aloe vera gel in drinking water for four weeks. They were compared with patient being fed just water. Patients drinking aloe vera gel showed marked improvement and remission above those whom were fed water only. No significant side effects were reported (Roussell, 2013).
While arguments advanced against alternative medicine mainly are aimed at discrediting their use due to lack of scientific evidence there is no difficulty in proving usefulness if only more researchers would spend the time evaluating these remedies with scientific research methodological applications subsequently documenting their value. Other alternative therapies applied to irritable bowel syndrome are yoga and acupuncture.
Combined treatment.Suggestions on how conventional and alternative medical therapies could be blended
Since there is just 50% success rate of medical treatment and surveys prove that 73% of patients looked forward to therapies in their treatment (Ducrotté, 2007). Attempts at combining the successes of medical treatment with alternative medicine can be a successful if health promotion strategy holistic approach towards its management is suggested. Some patients will respond poorly to single methods because there is a huge psychological etiological predisposition. Therefore, combining herbal remedies with psychotherapy could be a beneficial technique.
Risks or benefits. Assessment of the risks or benefits of combining conventional and alternative medical therapies.
Possible risks of combing conventional medicine with alternative are synergistic drug reactions. Therefore, clients must be educated regarding taking medicine with herbal remedies. If they are using herbs, medicines must be discontinued. Benefits of a holistic approach combining conventional with alternative are addressing the individual as a physical, social and spiritual being. Access to tolerable herbal remedies, psychotherapy, exercise, social activities and dietary education are the advantages of combining these methods.
Implications for nursing practice. Discussion of implications for nursing practice.
Since there is no cure for irritable bowel syndrome implications of attempting to combine conventional with medical interventions are medical practionners must let patients know that there are alternative to medicine. Alternative medicine practitioners must communicate their practice limitations to their patients/clients
Seventy three (73% ) looked forward to therapies, which provide hope and 63% needed more support in coping with the disease than which was presently available through medical science interventions (Ducrotté, 2007). Patients drinking aloe vera gel showed marked improvement and remission above those whom were fed water only. No significant side effects were reported (Roussell, 2013). These are two valuable developments, which ought to be considered in the future interventions of irritable bowel syndrome.
Ducrotté, P. (2007). Irritable bowel syndrome: current treatment options. Presse Med 36 (11);1619–26
Grove, W. Zald, D. Lebow, B.Snitz, B., & Nelson, C. (2000). Clinical versus mechanical prediction: A meta-analysis. Psychological Assessment 12 (1); 19–30.
Hulisz, D. (2004). The burden of illness of irritable bowel syndrome: current challenges and hope for the future. J Manag Care Pharm. 10 (4); 299–309
Mayer, E. ( 2008). Clinical practice. Irritable bowel syndrome. N. Engl. J. Med. 358 (16): 1692–9.
Rahimi, R. Shams-Ardekani, M. Abdollahi, M. (2010). A review of the efficacy of traditional Iranian medicine for inflammatory bowel disease. World journal of Gastroenterology: WJG, 16 (36), 4504–4514
Roussell, M. (2013). The Truth About Aloe Vera Juice:The newest miracle drink might not be as healthy as you think. Shape Magazine