Irritable Bowel Syndrome: What Helps And What Doesnt
There are a lot of treatments for the relief of irritable bowel syndrome but there’s a lack of good-quality research on them. Because it’s not clear what causes IBS, it’s difficult to find suitable treatments. But research has suggested that at least some medications and treatments may help.
The main symptoms of irritable bowel syndrome are abdominal pain, constipation and diarrhea. Most people only have mild symptoms that they can cope with fairly well without having treatment. Over time they learn to understand their body’s signals. But some people have more severe symptoms that greatly affect their everyday lives, so they look for a treatment to reduce the symptoms.
Choosing Otc Medications For Digestive Health
There is no one size fits all OTC medication for IBS. Irritable bowel syndrome is tricky, because we dont yet fully understand the cause. Treating IBS, unfortunately, isnt as simple as taking a single medication.
That doesnt mean there arent medications that can help to improve digestive health overall. These OTC medications wont always target a specific symptom. Instead, they work to improve the overall health of the digestive tract.
OTC medications for improving digestive health come in several forms, and in many cases research is ongoing. The most popular options are:
These medications may be able to provide some relief, but they work best as only a part of an overall treatment plan. Any OTC treatment for improving digestive health must be combined with a healthy diet, and frequent exercise. Peppermint oil and probiotics are a good starting place.
What Are The Symptoms Of Irritable Bowel Syndrome
Only a small number of people with IBS have severe symptoms most have mild-to-moderate symptoms that can be controlled by managing their diet, lifestyle or stress.
Symptoms can also vary significantly from one person to the next. Even within the same person, symptoms are generally not stable over a lifetime and can change without warning.
Some people are more likely to have constipation , others diarrhea , while a few experience both constipation and diarrhea at different times .
Most people with IBS have at least two of these symptoms:
- Altered bowel habits – passing feces more or less frequently than normal or periods of constipation and then periods of diarrhea
- Mucus mixed in with the feces
- Multiple episodes of stomach discomfort for at least three months of the past year
- Pain or discomfort that lessens after a bowel movement
- Swelling or bloating of the stomach, or a feeling of fullness soon after eating.
Increased stomach gurgling or bowel sounds are also reported frequently by people with IBS.
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What Is Ibs Treatment
No specific therapy works for everyone, but most people with IBS can find a treatment that works for them. Your healthcare provider will personalize your IBS treatment plan for your needs. Typical treatment options include dietary and lifestyle changes. A dietitian can help you create a diet that fits your life.
Many people find that with these changes, symptoms improve:
Dietary changes:
- Increase fiber in your diet eat more fruits, vegetables, grains and nuts.
- Add supplemental fiber to your diet, such as Metamucil® or Citrucel®.
- Drink plenty of water eight 8-ounce glasses per day.
- Avoid caffeine .
- Limit cheese and milk. Lactose intolerance is more common in people with IBS. Make sure to get calcium from other sources, such as broccoli, spinach, salmon or supplements.
- Try the low FODMAP diet, an eating plan that can help improve symptoms.
Activity changes:
- Try relaxation techniques.
- Eat smaller meals more often.
- Record the foods you eat so you can figure out which foods trigger IBS flare-ups. Common triggers are red peppers, green onions, red wine, wheat and cows milk.
Medical changes:
What happens if medications dont work?
In some cases, symptoms dont respond to medical treatment. Your provider may refer you for mental health therapies. Some patients find relief through:
What Ibs Symptoms Can Be Treated With Medication
There are multiple ways to treat IBS, but the goal of treatment is to focus on relieving what symptoms you are experiencing. Typically, the symptoms that can be treated with medication include abdominal pain and abnormal stool consistency .
Initial treatment may include dietary changes or other non-medicinal options . However, healthcare providers may also choose to start with medications to help relieve symptoms.
The current guidelines from the American College of Gastroenterology list no specific order in which treatments should be tried. Healthcare providers are encouraged to personalize their recommendations based on how the person is feeling and their medical history.
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What Is The Best Over
IBS, which stands for irritable bowel syndrome, is the most common worldwide gastrointestinal disorder. It affects as much as 10% to 15%¹ of the worlds population, and 25% of these cases are severe.
It’s a truly life-altering condition for some people, with symptoms that can include:
These symptoms can be very uncomfortable, and since IBS is so unpredictable and affects everyone differently, it can be particularly challenging to treat.
Although there is no cure, some IBS symptoms can be relieved by taking over-the-counter medications. Well be looking at the best options below.
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Stress Management For Ibs
Stress tends to make IBS symptoms worse. So therapies that can help you learn to handle these emotions can often help you find relief.
One technique that seems to help most people is behavioral therapy. It teaches you better ways to deal with pain and stress. Types include relaxation therapy, biofeedback, hypnotherapy, cognitive behavioral therapy, and psychotherapy.
If you want to try behavioral therapy for IBS, try to find a therapist who will work with your regular doctor.
Outside of formal therapy, you can try simple ways to reduce stress and ease IBS symptoms on your own. Meditation, regular exercise, getting enough sleep, and eating a well-balanced diet for your IBS can help.
Also, try to do something you enjoy every day. Take a walk, listen to music, soak in a bath, play sports, or read.
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Otc Medications For Diarrhea
Finding the right medication for treating diarrhea is often a matter of urgency. Targeted medications for diarrhea will rarely help with overall symptoms of IBS, but they can certainly help the immediate problem.
- Loperamide Commonly sold under the brand name Imodium, Loperamide is a popular OTC medication for short-term relief from diarrhea. Loperamide can have side effects such as constipation, cramps and dizziness, and should not be taken regularly without discussing with your doctor. Although it can help ease diarrhea, it will not help with other IBS symptoms like pain and bloating.
- Calcium Calcium is a traditional choice for treating diarrhea, and it does have a constipating effect. It should only be taken in the short-term, as it is possible to take too much. Calcium carbonate isnt widely recommended by doctors, but many IBS sufferers have found it helpful. It may also settle the stomach if you have indigestion .
- Bismuth Bismuth subsalicylate, often sold as Pepto-Bismol, is an antidiarrheal medication. A popular method for self-treatment, it does little to relieve any other symptoms of IBS.
Its important to be careful when taking diarrhea medication, and to only use it in the short term. Overuse can lead to constipation.
OTC medications for diarrhea can stop or ease diarrhea in the short term. However, they cant help with other IBS issues, such as stomach pain.
What Causes Irritable Bowel Syndrome And Who Is At Risk
Nobody knows what causes IBS but factors that appear to play a role include:
- Muscle contractions in the intestine
- Abnormalities in the nerves of the digestive system
- Inflammation in the intestines
- Severe infection
- Changes to the microflora in the gut.
Certain risk factors make you more likely to develop IBS. IBS is twice as likely to occur in women than men and more common in people under age 45, usually beginning in adolescence or early adulthood. If you have a family member with the disorder, you are also at higher risk of getting it. Psychological stress, caused by anxiety, depression, a personality or mood disorder, or a history of sexual abuse can bring on IBS.
IBS has also been associated with smoking, a low fiber diet, use of laxatives, or a bout of infectious diarrhea or other cause of temporary bowel inflammation. Hormonal changes may also play a role.
IBS is a persistent condition that requires long-term management.
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Which Is The Best Medicine For Irritable Bowel Syndrome
Sorbitol . Treatments for IBS depend on the predominating symptoms but may include: Newer agents that improve stool consistency and frequency. Ask your doctor what IBS treatment is best for you.
Are there any over the counter treatments for IBS?
In some cases, the drugs cause unpleasant side effects that lead people to go off of them. Luckily, medication is not the only available treatment for IBS. Your other options include over-the-counter remedies, dietary modifications, and psychological therapies.
The Benefits Of Talking With A Therapist For Ibs
For many people with IBS, emotional stress plays an important role in the frequency and severity of their symptoms.
Its important to have a discussion with your doctor about how stress might be contributing to your symptoms. If you both agree that stress, anxiety, or depression could be affecting your IBS, you may be referred to a mental health professional.
When you see a therapist, the following strategies may be used to improve your symptoms. It could also be beneficial to have a multidisciplinary team to support you, in which your doctor-led care includes a nutritionist and mental health professional, for example.
Cognitive behavioral therapy This type of talk therapy focuses on helping you change your patterns of thought and behavior. Years of research support its effectiveness as a treatment for IBS.
Gut-directed psychotherapyRelaxation training
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What Is A Functional Gi Disorder
IBS is a type of functional gastrointestinal disorder. These conditions, also called disorders of the gut-brain interaction, have to do with problems in how your gut and brain work together.
These problems cause your digestive tract to be very sensitive. They also change how your bowel muscles contract. The result is abdominal pain, diarrhea and constipation.
Alternative Therapy For Ibs
Some people with IBS try alternative therapies such as acupuncture, probiotics, and herbs to relieve their symptoms.
Keep in mind that most alternative therapies haven’t been tested for effectiveness in rigorous clinical trials the way other treatments have.
Researchers at the National Institutes of Health have found that acupuncture works for chronic pain. For IBS relief, however, the results have been mixed.
There is also some evidence that probiotics, “healthy” bacteria normally found in the gut, help some people with IBS. A study of one type, Bifidobacterium infantis, found that it improved IBS symptoms and day-to-day life after people took it for 4 weeks. Research on another type, lactobacillus, has had more mixed reviews.
Studies on herbs have been mixed. Some research has shown that peppermint relaxes colon muscles and may improve symptoms of IBS.
If you want to try acupuncture or herbs for your IBS symptoms, talk with your doctor first. Some herbs can affect how well other medications work.
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Medications Currently Available For The Treatment Of Irritable Bowel Syndrome
The literature search resulted in 43 studies meeting the inclusion criteria that assessed the efficacy of medications for the treatment of IBS. Table 2 describes the studies that met inclusion criteria and their respective outcomes, whereas table 3 describes the overall efficacy of each medication by IBS type and symptom. With few exceptions, many of the studies were limited by short treatment duration and follow-up, imprecise or variable methods of identifying IBS and subtype, and small sample sizes. Medications with the most robust evidence supporting their use for the treatment of IBS were lubiprostone, linaclotide, rifaximin, fiber supplementation and peppermint oil. Table 4 describes the proposed mechanism of action of the medications for treating IBS.
Table 2
Placebo-controlled trials assessing the efficacy of medications for the treatment of IBS symptoms
Table 3
Efficacy of medications for the treatment of specific IBS symptoms: clinical outcomes of placebo-controlled trials
Table 4
Mechanism of action of medications for the treatment of IBS
Lubiprostone
Given the clear evidence supporting the use, lubiprostone appears as a viable and preferred option for the treatment of IBS-C. Limiting lubiprostone’s use are its high cost and lack of long-term studies.
Linaclotide
Given the robust evidence supporting the use of linaclotide, linaclotide is a viable option for the treatment of IBS-C. Limitations of linaclotide’s use are its high cost and lack of long-term studies.
When Should I See A Healthcare Provider
See your provider if you have symptoms more than three times a month for more than three months. And if you have symptoms less often, but they interfere with your life, its a good idea to talk to your provider.
Some symptoms may point to a more serious problem. Contact your provider as soon as possible if you have:
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Diarrhea Compared To37% Placebo
Target 1 & 2 Study Design: Two identical, randomized, phase 3 trials conducted over a 3-month period. A total of 1258 patients meeting Rome II criteria for IBS received XIFAXAN 550 mg 3 times a day or placebo for 14 days. Primary endpoint was adequate relief of IBS signs and symptoms for at least 2 of 4 weeks during the month following 14 days of treatment. Adequate relief was defined as a response of yes to the weekly Subject Global Assessment question: In regards to your IBS symptoms, compared to the way you felt before you started study medication, have you, in the past 7 days, had adequate relief of your IBS symptoms? .Primary endpoint: 41% of patients in the XIFAXAN 550 mg group, 31% of TARGET 1 placebo group and 32% of TARGET 2 placebo group experienced adequate relief of IBS signs and symptoms. Composite endpoint was defined as 30% decrease from baseline in abdominal pain with a weekly average stool consistency score of < 4 for 2 weeks during the month following 2 weeks of treatment.
Keeping A Food And Symptom Diary
Some people with IBS may notice their symptoms worsening after they eat particular foods.
These individuals may benefit from writing down the foods that they eat throughout the day, along with any IBS symptoms that they experience.
This is called keeping a symptom diary.
The International Foundation for Gastrointestinal Disorders has created a symptom diary template that can help people with IBS better understand how their body reacts to certain foods.
Doing this can help them identify the foods that trigger their IBS so that they can exclude them from their diet.
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Drug Treatment For Ibs
Most of the pain experienced in IBS is caused by spasms that occur in the walls of your intestine. Antispasmodics such as hyoscyamine and dicyclomine relieve colicky-type pain and are good for occasional use. However, they do tend to cause side effects such as a dry mouth, drowsiness, and constipation. Peppermint oil capsules are an alternative to antispasmodics. It has a similar effect but without any side effects.
Loperamide stops diarrhea, although care must be taken not to overdo the dosage and end up with constipation.
Antidepressants are effective at relieving abdominal pain and providing overall symptom relief in people with IBS. However, side effects such as weight gain, drowsiness, constipation, and sexual dysfunction tend to limit their use for IBS.
Eluxadoline treats abdominal pain and diarrhea, hallmark symptoms of IBS-D. It is the first in its class and provides a welcome treatment alternative to standard anti-diarrheal medicines. It works on opioid receptors to relieve diarrhea and is classified as a controlled substance. Potentially it is a target for people who abuse prescription medicines or street drugs. Theoretically, there is a risk of psychological dependence.
Both Linzess and Amitiza soften stools and stimulate bowel movements, so they are effective in people with constipation-predominant IBS, but not so good for people who have diarrhea as their main symptom.
Selective Serotonin Reuptake Inhibitors
- These are usually prescribed as antidepressants, but theyve also shown to help move contents through the digestive system, preventing constipation.
- Studies have shown that SSRIs need to be taken between 4-8 weeks before symptoms are improved .
- Several randomised controlled trials found that SSRIs are no better at relieving the symptoms of IBS than a placebo .
- Side effects can include poor sleep, headaches, anxiety and nausea.
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Are There Ways To Treat Ibs Without Medications
As mentioned earlier, your healthcare provider may suggest non-medicinal treatments for you before using medications. Adding fiber to your diet, cognitive behavioral therapy , and relaxation techniques are all potential treatments your provider may have you try.
The ACG has recommended peppermint oil to help relieve abdominal pain, though results are mixed. The ACG has suggested that taking a coated capsule form of this product may help lessen or prevent side effects, such as heartburn. A more recent study disputes this claim, with results showing that the placebo was just effective as peppermint oil in improving IBS symptoms.
More research is needed to give a definitive answer on how beneficial this alternative method is. In either case, since dietary supplements are not regulated like prescription medications, its best to ask your healthcare provider for suggestions on which form of peppermint oil they would recommend if any.
Other treatments being explored for IBS include probiotics and fecal transplants. These treatments would aim to introduce healthy bacteria into the intestines to help improve symptoms. At this time however, they are not recommended by the ACG, as evidence for their benefit is limited.