How do doctors treat IBS?
Though irritable bowel syndrome (IBS) doesn’t have a cure, your doctor can manage the symptoms with a combination of diet, medicines, probiotics, and therapies for mental health problems. You may have to try a few treatments to see what works best for you. Your doctor can help you find the right treatment plan.
Changes in eating, diet, and nutrition
Changes in eating, diet, and nutrition, such as following a FODMAP diet, can help treat your symptoms.
Your doctor may recommend medicine to relieve your symptoms.
- Fiber supplements to relieve constipation when increasing fiber in your diet doesn’t help.
- Laxatives to help with constipation. Laxatives work in different ways, and your doctor can recommend a laxative that’s right for you.
- Loperamide to reduce diarrhea by slowing the movement of stool through your colon. Loperamide is an antidiarrheal that reduces diarrhea in people with IBS, though it doesn’t reduce pain, bloating, or other symptoms.
- Antispasmodics, such as hyoscine, cimetropium, and pinaverium, help to control colon muscle spasms and reduce pain in your abdomen.
- Antidepressants, such as low doses of tricyclic antidepressants and selective serotonin reuptake inhibitors, to relieve IBS symptoms, including abdominal pain. In theory, because of their effect on colon transit, tricyclic antidepressants should be better for people with IBS with diarrhea, or IBS-D, and selective serotonin reuptake inhibitors should be better for people with IBS with constipation, or IBS-C, although studies haven’t confirmed this theory. Tricyclic antidepressants work in people with IBS by reducing their sensitivity to pain in thegastrointestinal (GI) tract as well as normalizing their GI motility and secretion.
- Lubiprostone (Amitiza) for people who have IBS-C to improve abdominal pain or discomfort and constipation symptoms.
- Linaclotide (Linzess) for people who have IBS-C to relieve abdominal pain and increase how often you have bowel movements.
- The antibiotic rifaximin to reduce bloating by treating small intestinal bacterial overgrowth. However, experts are still debating and researching the use of antibiotics to treat IBS.
- Coated peppermint oil capsules to reduce IBS symptoms.
Follow your doctor’s instructions when you use medicine to treat IBS. Talk with your doctor about possible side effects and what to do if you have them.
Some medicines can cause side effects. Ask your doctor and your pharmacist about side effects before taking any medicine.MedlinePlus maintains the latest information about side effects and drug warnings.
Your doctor may also recommend probiotics. Probiotics are live microorganisms—tiny organisms that can be seen only with a microscope. These microorganisms, most often bacteria, are like the microorganisms that are normally present in your GI tract. Studies have found that taking large enough amounts of probiotics, specifically Bifidobacteria and certain probiotic combinations, can improve symptoms of IBS. However, researchers are still studying the use of probiotics to treat IBS.
You can find probiotics in dietary supplements, such as capsules, tablets, and powders, and in some foods, such as yogurt.
Discuss your use of complementary and alternative medical practices, includingprobiotics and dietary supplements, with your doctor.
Therapies for mental health problems
Psychological therapies may improve your IBS symptoms.
Learning to reduce stress can help improve IBS. With less stress, you may find you have less cramping and pain. You may also find it easier to manage your symptoms.
Some options for managing stress include
- taking part in stress reduction and relaxation therapies such as meditation
- getting counseling and support
- taking part in regular exercise such as walking or yoga
- reducing stressful life situations as much as possible
- getting enough sleep
Talk therapy may reduce stress and improve your IBS symptoms. Two types of talk therapy that health care professionals use to treat IBS are cognitive behavioral therapy and psychodynamic, or interpersonal, therapy. Cognitive behavioral therapy focuses on your thoughts and actions. Psychodynamic therapy focuses on how your emotions affect your IBS symptoms. This type of therapy often involves relaxation and stress management techniques.
In gut-directed hypnotherapy, a therapist uses hypnosis to help you relax the muscles in the colon.
Mindfulness training can teach you to focus your attention on sensations occurring at the moment and to avoid catastrophizing, or worrying about the meaning of those sensations.