Treatment for irritable bowel syndrome can be as complicated as the disease itself. In addition to IBS medication, a doctor may recommend probiotics, a diet change, supplements, or over the counter medications for symptoms. In the article below, we’ll take a look at IBS medication for different subsets of IBS, including IBSD. We’ll also have a look at some Irritable Bowel Syndrome diet choices. Finally, we’ll talk about probiotics, and the role they may play in easing symptoms.
There are a number of medications that treat IBS. First, there is specific IBS medication. This includes IBS-C medication and IBS-D medication. Additionally, there are medicines that treat IBS symptoms. Finally, there are probiotics. Doctors may prescribe one kind of medication or a combination of different kinds.
Specific IBS medication
Which IBS medication is right for you depends on whether you deal more with constipation or diarrhea — or whether you have a mix of both, which is common.
Common IBS medication for constipation includes:
Lubiprostone (Amitiza). Doctors sometimes prescribe Lubiprostone for women with constipation-predominant IBS. Generally, doctors will only prescribe it if the women have severe symptoms that haven’t responded to other treatments. It works by increasing fluid secretion in the small intestine to help with the passage of stool.
Linaclotide (Linzess). Linaclotide is also prescribed for constipation-predominant IBS. Like Lubiprostone, Linaclotide increases fluid secretion in the small intestine.
The most common types of IBS medication for diarrhea include the following:
Alosetron (Lotronex) Alosetron is a drug specifically for severe cases of diarrhea-predominant IBS (IBSD) in women who haven’t responded to other treatments. Because of the possibility of severe side effects, its use is strictly limited. Only doctors participating in a special program may prescribe it. In addition, Alosetron does not have approval for use in men.
Eluxadoline (Viberzi). Eluxadoline is also aimed at diarrhea-predominant IBS (IBSD). It reduces muscle contractions and fluid secretion in the intestine. In addition, it increases muscle tone in the rectum. Side effects can include nausea, abdominal pain, and mild constipation. Occasionally it can also cause pancreatitis.
Rifaximin (Xifaxan). Rifaximin is an antibiotic. It can decrease bacterial overgrowth, and therefore diarrhea.
Other medication for IBS symptoms
A doctor may also recommend some of the following IBS medication, in order to ease specific symptoms.
Fiber supplements. Fiber supplements like psyllium (Metamucil) increases the bulk of the stool. As a result, this helps to control constipation.
Laxatives. If fiber doesn’t help symptoms, a doctor may prescribe a laxative.
Anti-diarrheal medications. If diarrhea is a problem, a doctor may also prescribe an over the counter anti-diarrheal, like Immodium. Additionally, a doctor may prescribe a bile acid binder, such as cholestyramine (Prevalite), colestipol (Colestid) or colesevelam (Welchol).
Anticholinergic medications. Medications such as dicyclomine (Bentyl) can help relieve painful bowel spasms. A doctor may prescribe them to help control bouts of diarrhea.
Pain medications. Certain pain medications like Pregabalin (Lyrica) and gabapentin (Neurontin) can ease severe pain and bloating.
SSRI antidepressants. Selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (Prozac, Sarafem) or paroxetine (Paxil), may help patients who are both depressed and have pain and constipation.
Tricyclic antidepressants. IBS sufferers sometimes also suffer from depression or anxiety or both. In addition to relieving depression, antidepressants can inhibit the activity of the neurons that control the intestines. If no depression is present, a lower than normal dose can help to reduce IBS pain. Some tricyclic antidepressants include imipramine (Tofranil), desipramine (Norpramin), and nortriptyline (Pamelor).
The human digestive tract has billions of helpful bacteria, yeast, and other microorganisms. Sometimes these microorganisms become unbalanced. As a result, this can cause digestive distress. IBS patients, in particular, often experience an overgrowth of certain intestinal bacteria.
Probiotics are live bacteria or yeast found in foods and supplements. Some people believe that supplementing your diet with probiotics can ease IBS symptoms by restoring the balance. But it’s not enough to just buy something with the word “probiotic” on the label. It’s important to find the right kind. In fact, the wrong kind of probiotic can make symptoms even worse.
If you’re interested in exploring probiotics further, it’s important to speak to your doctor and/or dietitian. If they agree that probiotics may help, then they can give you expert guidance about which you might find beneficial.
The best probiotics for IBS
There are many different kinds of probiotics, and each of them may affect your symptoms in a different way. Some strains have shown promise for treating some symptoms, and other strains may help other symptoms. However, there have been inconsistencies between studies. More research is needed to determine the effectiveness of different strains for different symptoms.
You can read more about the latest research into the use of probiotics for IBS at Healthline.
Irritable Bowel Syndrome Diet
There is no one Irritable Bowel Syndrome Diet. Every person’s IBS is different. And different people may respond to different diets. If you have an IBS diagnosis, work with your doctor, and with a dietitian or nutritionist to figure out what will work best for your IBS. Below are five different kinds of diets that have provided relief to IBS sufferers.
High fiber diet
Some IBS sufferers experience constipation (IBS-C), or constipation alternating with diarrhea (IBS-M). For these patients, a diet rich in plant fiber may help to ease this symptom. Everyone should eat between 20 and 35 grams of fiber per day. Unfortunately, most Americans eat only between 5 and 14 grams. Good sources of dietary fiber include fresh fruits and vegetables, beans and pulses, oatmeal, and bran flakes. If you want to add more fiber to your diet, check out this article, which lists various foods along with their fiber content.
Low fiber diet
Other IBS Sufferers experience primarily gas and diarrhea (IBSD). For IBSD patients, a high fiber diet may make these problems worse. As a result, these patients may want to consider a low fiber diet. But it’s important not to cut out the fiber completely. Rather, concentrate on foods with soluble fiber, like apples, berries, carrots, and oatmeal. Foods with insoluble fiber, like cabbage, whole grains, nuts, tomatoes, raisins, and broccoli, may make symptoms worse. The U.S. National Library of Medicine has more information about soluble and insoluble fiber at their website.
Gluten is a protein found in products made from the grains wheat, barley, and rye. This includes bread, pasta, crackers, cereals, and more. Gluten can damage the intestines in people who are gluten-intolerant. Some people with a gluten intolerance also experience IBS. In such cases, a gluten-free diet may reduce symptoms. If your doctor or nutritionist suggests, try eliminating barley, rye, and wheat from your diet, to see if symptoms improve. The Celiac Disease Society has a list of foods containing gluten. And some of them might surprise you.
High-fat foods are often low in fiber. As a result, a diet rich in high-fat foods can significantly worsen IBS symptoms. And if a patient’s IBS includes constipation, this can make it worse. In addition, fatty foods can also be bad for people with mixed IBS, that is, IBS with a combination of constipation and diarrhea. In order to cut down on dietary fats, try to avoid fried foods and animal fats. Instead, try to eat more lean meats, fish, fruits, and vegetables.
Low FODMAP diet
The term “FODMAP” is an acronym for Fermentable Oligo-, Di-, Mono-saccharides, and Polyols. That’s a complicated way of saying a subset of carbohydrates that are known for triggering bloating, gas and stomach pain. Because these are also IBS symptoms, avoiding foods containing these kinds of carbohydrates can help you to manage your IBS. Some of the kinds of foods a person on a low FODMAP diet might avoid include wheat, rye, legumes, garlic and onions (which contain Oligosaccharides); dairy products (disaccharides); certain fruits like figs and mangoes, along with fructose sweeteners like honey and agave nectar (monosaccharides); and other fruits and vegetables like blackberries and lychee, along with certain low calorie sweeteners (polyols). In addition, you can read more about FODMAP foods at Healthline.
IBS is a chronic condition, and its symptoms can be unpleasant. Fortunately, there are many different ways to manage the symptoms. Talk to your doctor to see which medications, supplements, and dietary changes, may work for you.