Medications
Medicine may be used along with
lifestyle changes to manage symptoms of
(IBS).
The goal
of medicine treatment is to relieve your symptoms enough to prevent them from
interfering with your daily activities, because it may not be possible to
eliminate your symptoms. Medicines may be prescribed to treat moderate to
severe pain, diarrhea, or constipation that does not respond to home treatment.
No single medicine has been shown to be effective in relieving IBS over the
long term.
Medication Choices
In most cases, the choice of medicine is based on your
most troublesome symptom. For example, if diarrhea is the most bothersome
symptom, using antidiarrheals or anticholinergics may be helpful.
For diarrhea
Medicines that may be used to
treat severe diarrhea that does not improve with home treatment include:
- Antidiarrheals, including diphenoxylate (such as Lomotil) and
loperamide (such as Imodium), which slow intestinal movements.
- Bile acid binding agents, including cholestyramine (such as Questran), which
prevent bile acids from stimulating the colon, slowing the passage of stools
and relieving diarrhea.
- (Lotronex), which is used for some women who
have severe diarrhea and who have not responded to other treatments. This
medicine slows the movement of stools through the bowels.
For constipation
There are many medicines for severe
constipation that does not improve with home treatment. Most of these medicines are available without a prescription and are okay to take once in awhile. Check with your doctor before you use any of these medicines every day for constipation. Medicines for constipation include:
- Lubiprostone (Amitiza), which works by increasing the amount
of fluid in your intestines, making it easier for stool to pass.
- Osmotic laxatives (such as Milk of Magnesia and nonabsorbable
sugars such as lactulose), which work by holding fluids in the intestine and
drawing fluids into the intestine from other tissue and blood vessels. This
extra fluid in the intestines makes the stool softer and easier to pass.
- Polyethylene glycol (such as MiraLax), which helps the stool hold on
to more water, making it softer and easier to pass.
- Stimulant laxatives (such as Senokot), which speed up how fast stool moves through the intestines by
irritating the lining of the intestines.
For pain and cramping
The following medicines
may be used for long-term pain and cramping:
- , including dicyclomine
(Bentyl), which help prevent or relieve painful cramping spasms in the
intestines
- Antidepressants, including desipramine (such as Norpramin), which in low doses can help with pain caused by IBS