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. mentha oil and irritable bowel fiber fight For some patients, the best therapy for irritable bowel syndrome (IBS) may be old and cheap drugs such as fiber, antispasmodics and mentha oil, according to a new study finds. According to the researchers, these simple treatments have lost popularity due to the availability of newer drugs (and expensive), some of which have been recalled due to safety concerns. But traditional therapies should be part of the first-line treatments in guidelines for medications to treat IBS, experts say. "For physicians, IBS can sometimes be very difficult to treat," said lead researcher Dr. Alex Ford, Center for Health Sciences at McMaster University in Ontario, Canada. "They are always developing new drugs, but some of the most recent as alosetron and tegaserod have been withdrawn from the market, and are only available on a limited, well not yet been shown to be effective renzapride" he said. Moreover, "the older drugs that are cheap, safe, and in some cases are available without prescription, seem to be more effective in treating IBS." The report was published online Nov. 14 in BMJ. Up to 45 million Americans may have IBS, reports the International Foundation for Functional Gastrointestinal Disorders. Between 60 and 65 percent of IBS sufferers are women. advertising Besides pain and discomfort, people with IBS experience chronic or recurrent constipation, diarrhea, or attack them. Although the exact cause of the disease, the symptoms seem to result from an alteration in the interaction of the intestine, brain and nervous system, according to the foundation. For the study, Ford's team reviewed trials that compared IBS treatment with antispasmodics, fiber and mentha oil with placebo or no therapy. In trials involving over 2,500 patients with IBS. The researchers found that fiber, antispasmodics and mentha oil were effective treatments for IBS. Specifically, this meant that to prevent IBS symptoms in one patient, had to treat 11 people with fiber, five with antispasmodics, and 2.5 with mentha oil. There were no serious side effects associated with any of these treatments, the researchers wrote. Apparently mentha oil was the most effective therapy treatments reviewed, the researchers found. In trials comparing fiber with placebo, insoluble fiber such as bran was not effective. Instead, only soluble fiber such as ispaghula husk reduced symptoms. As for antispasmodics, the most effective was hyoscine. This drug is one that should be used first among antispasmodics, Ford's group recommended. "Physicians, particularly primary care, who are called to take responsibility for the treatment of IBS, should consider using these agents as first-line therapies for IBS," Ford said. Dr. Roger Jones, from Kings College London and author of an accompanying editorial in the journal, welcomed the study. "These treatments may be slightly more effective than recently thought and worth trying," Jones said. For some patients with pain and diarrhea, antispasmodics may be useful. Patients with constipation should try fiber and other patients mentha oil, Jones said. "If you have IBS is not well controlled or not feeling happy with the profile of symptoms should visit their primary care physician or gastroenterologist for review and perhaps remind you that there is new evidence on the effectiveness of these traditional treatments and would like try, "said Jones. "On the other hand, if you are very knowledgeable and confident, you can go to the pharmacy and

get these treatments for yourself," added Jones.