Invisible Illness by A. Arroll Megan P. Dancy Christine

Author:A. Arroll, Megan, P. Dancy, Christine
Language: eng
Format: epub
Publisher: SPCK

6

Treatments

Manage the whole disorder, be realistic.

(Dr Anish Bahra, neurologist, speaking at the ‘Migraine and Me’ conference, Royal Society of Medicine, London, April 2013)

This chapter outlines a number of suggested treatments and management strategies that have been used in the long-term conditions covered in this book. This is simply a review of available information and should not be a replacement for medical advice. However, the suggestions we give may help you to be aware of the various options and also to gain appropriate treatment.

Medications

As different drugs can be beneficial to different conditions, we take each invisible illness in turn for this sub-section.

IBS

A number of medications can be used to manage the symptoms of IBS. These will not resolve the underlying problem but can help with constipation, diarrhoea, pain, and so on. Anti-spasmodic medicines such as mebeverine and therapeutic peppermint oil can diminish pain and cramping by relaxing the muscles in the digestive system. Like all drugs, there can be side effects (although these are rare). For example, peppermint oil can cause heartburn.

Perhaps surprisingly, anti-depressants can also be used if anti-spasmodic medications have not been successful at reducing pain and cramping. Two types of anti-depressants can be used to treat IBS – tricyclic anti-depressants (most commonly amitriptyline) and selective serotonin reuptake inhibitors (SSRIs) such as citalopram, fluoxetine and paroxetine. Anti-depressants work by altering some of the chemicals in the brain known as neurotransmitters, which are released by nerve cells to send signals to other nerve cells. Tricyclic anti-depressants raise the levels of the serotonin and noradrenaline, and SSRIs increase serotonin, known as the ‘happiness hormone’ because it plays an important part in mood regulation. People with depression have been shown to have fewer serotonin receptors, which is why SSRIs can help with depression in some people. Tricyclic anti-depressants can have side effects (dry mouth, constipation, blurred vision and drowsiness), although these usually lessen after a few days of taking the medicine. They are not suitable if you have some cardiac problems. The side effects of SSRIs include blurred vision, diarrhoea or constipation, and dizziness. If the side effects do not go away, your doctor may suggest a different anti-depressant to see if that works better for you. For tricyclic anti-depressants to work, they must be taken consistently as they will only provide symptom relief as the body starts to get used to them, usually three to four weeks after starting the course. They are not a ‘quick fix’ and should be supervised by your doctor.

For diarrhoea, anti-motility medicines such as loperamide may help. These work by reducing the rate at which food progresses through the digestive system by slowing down the muscle contractions in the bowel. However, loperamide can cause abdominal cramps and bloating, dizziness, drowsiness and skin rashes, and it should not be taken by pregnant women.

For constipation, bulk-forming laxatives can be used. These are fibre supplements and work in the same manner as fibre that you eat by enabling the retention of fluid in the stool, which makes them easier to pass.

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