Understand IBS Treatment Expectations

The U.S. Food and Drug Administration (FDA) has approved several medications specifically for the treatment of IBS. While your healthcare provider may prescribe medications to treat other specific symptoms, these were approved to specifically treat IBS:

• Alosetron hydrochloride (Lotronex): The FDA approved this medication for the treatment of IBS with diarrhea (IBS-D). The medication is a 5-HT3 blocker.
• Eluxadoline (Viberzi): In May 2015, the FDA approved this medication for the treatment of IBS-D. This medication is designed to affect the nervous system by reducing bowel contractions that cause diarrhea.
• Lubiprostone (Amitiza): This medication is used to treat IBS with constipation (IBS-C) in women ages 18 and older. It works by activating chloride channels in the body to reduce symptoms of constipation.
• Rifaximin (Xifaxan): The FDA also approved this antibiotic to treat IBS in May 2015. This medication is intended to be taken three times a day for 14 days to reduce the symptoms of IBS-D. While doctors don’t know exactly how the drug works, Xifaxan has been thought to affect the bacteria in your gastrointestinal (GI) tract to reduce symptoms associated with IBS-D.

Your healthcare provider may consider the nature and severity of your symptoms before prescribing these medications.

Your healthcare provide may prescribe other medications to treat specific symptoms associated with your IBS. Examples could include diarrhea, constipation, cramping, and anxiety. Many of these medications are intended to be taken when your symptoms worsen, not taken daily.

Although some are available over the counter, you should talk to your healthcare provider before starting to take them. This way you can be sure they won’t interact with other medications you’re taking or negatively affect your health.

• Antidepressants: Anxiety, stress, and depression can contribute to your IBS symptoms. Antidepressants can help to reduce these effects. Examples include fluoxetine (Prozac), sertraline (Zoloft), and citalopram (Celexa).
• Anti-diarrheals: Some of these medications affect the muscles in your GI tract, slowing down the rapid contractions that can lead to diarrhea. Examples include loperamide and diphenoxylate.
• Antispasmodics: These medications reduce the cramping that can occur with IBS. Some are herbal remedies. Examples include belladonna alkaloids, hyoscyamine, and peppermint oil.
• Bile acid sequestrants: These are used if you have ongoing diarrhea despite the use of anti-diarrheal medications. However, side effects include abdominal pain, bloating, gas, and constipation, which may limit their use. Examples include cholestyramine and colesevelam.
• Fiber supplements: These supplements can increase the bulk in your stool as well as make it easier to pass. They’re often used to reduce constipation.
• Laxatives: These medications treat constipation. Some soften the stool. Others stimulate the bowel and make it easier to have a bowel movement. Examples include lactulose, milk of magnesia, and polyethylene glycol 3350 (MiraLAX).
• Probiotics: While these haven’t been fully proven to reduce IBS symptoms, some people take them to restore the balance of bacteria in the digestive tract.

Ideally, lifestyle changes can help you control your IBS. However, if your symptoms worsen or affect your daily life, your healthcare provider may prescribe one or more of these medications.

Sometimes treatments for IBS don’t come in pill form. Because diet, stress, and anxiety can all play roles in worsening IBS, lifestyle changes could reduce your symptoms. One place to start is your diet.

Some foods can cause uncomfortable gas and bloating. Your healthcare provider may recommend eliminating veggies like broccoli, cauliflower, and cabbage to see if your symptoms improve. Carbonated drinks and raw fruits may also cause excess gas and bloating.

Another potential change is transitioning to a low FODMAP diet. FODMAP stands for fermentable oligo-, di-, and monosaccharides and polyols. These types of carbohydrates can irritate the digestive tract when you have IBS.

An elimination diet, where you stop eating these food types to see if your symptoms improve, may be recommended. You may then slowly reintroduce some of the foods. If your symptoms come back, you know which food could be one of the causes.

Examples of high-FODMAP foods include asparagus, apples, kidney beans, split peas, grapefruit, processed meats, raisins, and wheat-containing products.

Sometimes adding fiber into your diet can help reduce the effects of constipation.

However, high-fiber foods may be high-FODMAP foods. Examples include whole grains, vegetables, beans, and fruits. Adding these foods slowly into your diet can help reduce the potential side effects.

Stress relief is another important lifestyle aspect when you have IBS. Getting plenty of rest and exercising can help reduce daily stress. Try activities such as yoga, meditation, tai chi, journaling, and reading.

Taking a little quiet time for yourself — even just 15 minutes a day — can help relieve feelings of stress and pressure. You may benefit from seeing a therapist who can help you recognize stressors in your life and learn how to cope.

Quitting smoking is another important lifestyle change when you live with IBS. Cigarette smoking can cause reactions in your body that make the bowel more irritable. Quitting smoking is not only good for your health in general, it also helps to reduce your IBS symptoms.

IBS is a condition that has its ups and downs. The disorder may worsen with stress, hormone fluctuations, and illness. Sometimes, IBS flares up for seemingly no apparent reason. There’s no cure for IBS, but it can be managed.

Talk to your healthcare provider about how you can control your symptoms through lifestyle changes, medications, or a combination of both.