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IBS-C: New Treatments Deliver Promising Management

Currently, treatment for irritable bowel syndrome with constipation (IBS-C) focuses on treating symptoms, preventing flares, and avoiding triggers. Lifestyle adjustments are common. These changes include eating more fiber, drinking more water, exercising regularly, and eliminating problematic foods. Very few medications for IBS-C exist.

Treatment for IBS-C is not one-size-fits-all. What works for you may not work for another person. However, advances in treatments are good for everyone. Each year, researchers and doctors investigate potential treatments for people living with this common digestive disorder. Many of these hold promise for the future.

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Medications currently or newly approved for IBS-C

The U.S. Food and Drug Administration (FDA) has approved two medications for the treatment of IBS-C:

Lubiprostone

In 2008, the FDA approved lubiprostone (Amitiza) for the treatment of IBS-C. At the time, it was the only FDA-approved medication for IBS-C. Lubiprostone increases the fluid your small intestine secretes. The extra fluid helps pass stool more easily, which reduces your risk for constipation.

Lubiprostone is only available for use in women ages 18 and older. Men and children with IBS-C shouldn’t use it. Side effects include nausea, abdominal pain, and diarrhea.

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Linaclotide

In 2012, the FDA approved linaclotide (Linzess) for the treatment of IBS-C. This medicine is also approved for the treatment of chronic idiopathic constipation (CIC). This type of constipation occurs regularly and doesn’t respond to typical treatments.

Linaclotide helps ease the symptoms of IBS-C by spurring more frequent bowel movements. It can also ease abdominal pain. The most common side effect of this medicine is diarrhea.

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Medications on the horizon for IBS-C

Researchers and pharmaceutical companies are investigating and developing newer treatments for people living with IBS-C. Of course, the ultimate goal is a cure. But until that time, new developments hold great promise. Some of these developments involve medications, and some are more lifestyle focused. Here is what you might expect to see in the future:

Plecanatide

In 2017, the FDA approved plecanatide (Trulance) for the treatment of CIC. Currently, it’s not prescribed to individuals with IBS-C. However, the medication holds promise for these people, and the manufacturer says it’s being evaluated for that purpose.

Like lubiprostone, plecanatide works in the upper gastrointestinal (GI) tract to stimulate fluid produced by the intestines. The extra fluid makes passing bowel movements easier. The extra fluid can also help maintain regular GI function.

Bile acid modulators

A class of drugs called bile acid modulators has been used to treat constipation. Bile is a fluid produced by your liver. After a meal, your liver sends more bile into your stomach and intestines via the gall bladder. Researchers discovered that this medication might move food and waste through your GI more quickly. This type of medicine could alter the level of bile in your GI tract, and that could help stimulate your bowels if you’re constipated.

Probiotics

Your intestines are filled with billions of bacteria and microorganisms. The balance of “good” bacteria may play a role in your overall health. Probiotics are good bacteria. Research suggests having a healthy balance of probiotics in your gut may ease symptoms of IBS, including pain and gas.

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Building up and maintaining healthy bacteria in your body may help improve IBS-C symptoms. You can increase your supply of probiotics by eating foods that are filled with this good bacteria or taking supplements.

Currently, existing studies are limited, but the future holds great promise for understanding the relationship between your bacteria and your gut health.

Targeted bacterial treatments

Eating more probiotics is healthy for many reasons, but a targeted bacterial approach may be more successful. Research suggests a cocktail of highly specific bacteria may help disrupt any bacterial imbalance in your GI tract and reduce or eliminate symptoms.

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Fecal transplants

Healthy bacteria may play another role in treating IBS-C. This time the treatment involves what comes out of your body, rather than what goes in. Studies are limited, but research suggests a fecal transplant may transfer healthy bacteria from one person’s GI tract to another. The goal is to help good bacteria colonize in the bowels so that symptoms of gastrointestinal disease will be reduced or eliminated.

What now?

Talk with your doctor about these and other treatments that might hold promise for you. Some of these are years from being available, but others could be right around the corner.

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Make sure you keep regular appointments with your doctor so you can stay on top of new ideas, new medications, and new treatment options. Let your doctor know you would like to consider something different if you could be a good candidate for it.

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