Irritable bowel syndrome (IBS) is a disorder that affects the intestines. Canada has one of the highest rates of IBS in the world. It is estimated that 18% of Canadians suffer from IBS, compared to 11% globally. For those suffering from IBS, the condition can certainly have a large negative impact on day to day life. More than 70% of people with IBS indicate that their symptoms interfere with everyday life, and 46% report missing school or work due to IBS.

What is IBS?

IBS is a chronic condition that affects the intestines. In IBS, the sensitivity and motility of the intestine are affected, leading to various symptoms. Although the symptoms are distressing, IBS is not typically a life-threatening condition and doesn’t typically put you at higher risk of other serious conditions.

Symptoms of IBS include:

  • Abdominal pain that tends to get better after bowel movement
  • Change in frequency of bowel movements: either diarrhea or constipation
  • Bloating
  • Cramps in the abdomen
  • Changes in the consistency of bowel movements
  • Increase in gas
  • Mucus in the stool 

IBS symptoms can be improved by dealing with stress through regular exercise, relaxation, or therapy. Some people find changes in their diet helps relieve symptoms, although this varies from person to person. . Symptoms can also be treated with medication.

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Management of IBS

There is no cure for IBS currently, but various medications are helpful for controlling symptoms so they interfere less with your day-to-day life. Some people are able to manage IBS through changes in their diet, regular exercise, and lifestyle changes to reduce stress. Others use one or more medications to help control symptoms. Every person with IBS responds to treatment differently. Depending on your symptoms, medical history, and other factors, your doctor may recommend different medications. A few of the common options are explained below. 

Antidiarrheal for IBS

Physicians often prescribe antidiarrheal drugs to patients with IBS who experience diarrhea as a main symptom. 

What are they?

Antidiarrheal medications can help ease symptoms of diarrhea and prevent excessive loss of fluids from the body. 

Why are they used for IBS?

IBS with diarrhea is a specific type of IBS (IBS – D). Antidiarrheal medications decrease the movement of your gut smooth muscles and the movement of fluids into the intestine. Also, they increase fluid reabsorption, which helps decrease fluid loss from the body. 

What are the most popular antidiarrheal medications used for IBS?

Various antidiarrheal medications treat IBS-D (a type of IBS with diarrhea as its main symptom).

  • Loperamide (Imodium, Diarest, Diarr-Eze) – Loperamide is an over-the-counter (OTC) antidiarrheal medication widely used to treat IBS symptoms. It reduces gut transit, solidifies loose stools, and decreases the frequency of diarrhea episodes. Loperamide is a pill taken as needed after each loose bowel movement, up to 8 tablets per day. Common side effects of loperamide include constipation and dizziness. 
  • Eluxadoline (Viberzi) – Eluxadoline is a prescription medication that Health Canada has approved for IBS-D treatment. It works by slowing your gut’s motion, thus decreasing the symptoms, such as abdominal pain and diarrhea. Eluxadoline is a pill taken twice a day. The side effects of eluxadoline include nausea, headache, and pancreatitis (inflammation of the pancreas where you may have sudden severe abdominal pain). 

Gut antispasmodic for IBS

Various medications belonging to this class can help reduce symptoms of IBS, especially abdominal pain and cramping. Physicians may prescribe these medications depending upon your symptoms.

What are they?

Antispasmodics are medications that stop or reduce the contraction of smooth muscles in the gastrointestinal tract.

Why are they used for IBS?

The medications belonging to this class decrease the intestinal contraction that helps reduce abdominal discomfort and pain. 

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What are the most popular gut antispasmodic medications used for IBS?

  • Dicyclomine (Bentylol, Lomine, Protylol, Formulex) – It is one of the most commonly used medications and belongs to the anticholinergics class. It helps to decrease intestinal and stomach cramps. It also reduces gut movement by relaxing the smooth muscles in the stomach and the intestine. Dicyclomine can cause side effects like dizziness, dry mouth, dry eyes, and skin flushing.
  • Hyoscine butylbromide (Buscopan) – It is also one of the most popular medications. Dicyclomine and hyoscine belong to the same class of medication (anticholinergics). It has similar actions and similar side effects as dicyclomine

Laxative for IBS

Your physician may prescribe you laxatives if you experience constipation as a symptom. 

What are they?

Laxatives are medications that increase the frequency or softness of bowel movements  in patients experiencing constipation as a symptom of IBS. Most of the laxatives discussed are available over-the-counter (OTC). 

Why are they used for IBS?

Patients who suffer from IBS-C (a type of IBS where patients suffer from constipation) experience small, hard stools that are difficult to pass. These medications help increase bowel movements and provide relief from constipation. 

What are the most popular laxative medications used for IBS?

  • Polyethylene glycol (PEG) 3350 (MiraLAX, RestoraLAX) – PEG 3350 is an osmotic laxative available as an OTC product. It works by absorbing and holding more moisture in the stool to soften it and increase bowel movements.
  • Bisacodyl (Rexall, Dulcolax, Bisacodyl Odan) – It is a stimulant that acts by increasing the movement of the intestines to promote passing of stools
  • Linaclotide (Constella) – Health Canada has approved this medicine to treat constipation, mainly in patients with IBC-C and idiopathic constipation in men and women. It works by increasing fluids in your intestines and speeding up food movement through your gut. It also helps to decrease symptoms, such as bloating and abdominal pain or discomfort. 

Nerve pain medication for IBS

Sometimes, your physician may prescribe you nerve pain medications to reduce symptoms of IBS. 

What are they?

Nerve pain medications work by decreasing the transmission of pain signals to the brain from over-sensitive nerve cells. .

Why are they used for IBS?

In people with IBS, the nerves of the gut seem to be extra sensitive. Nerve pain medications help reduce nerve sensitivity to more normal levels to decrease IBS symptoms, such as bloating and severe pain.

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What are the most popular nerve pain medications used for IBS?

Both of the medications listed below are prescription medications that your physician may prescribe to help treat severe pain and bloating:

  • Gabapentin  (Neurontin
  • Pregabalin (Lyrica) 

Antibiotics for IBS

In some cases of IBS, your physician may prescribe antibiotics depending on your symptoms. 

What are they?

These medications reduce bacterial overgrowth in the gut. 

Why are they used for IBS?

Research indicates that they work by decreasing the bacterial growth that causes diarrhea. It is mainly used to treat patients with IBS-D (a type of IBS with diarrhea as its symptom).

What are the most popular antibiotics medications used for IBS

Rifaximin (Zaxine) is the only antibiotic that Health Canada has approved for the treatment of IBS. It is a pill taken 3 times a day for 2 weeks. The 2-week course may be repeated every 2-3 months if you need. 

Dietary supplement for IBS

Various alternative medicines have helped reduce the symptoms of IBS. You should consult your doctor about which alternative medications can help to decrease your IBS symptoms.

What are they?

Various supplements like probiotics, peppermint oil, or specific yoga poses, meditation, or hypnosis have been used to relieve symptoms of IBS.

Why are they used for IBS?

Supplements like probiotics and peppermint oil may help reduce inflammation or gut spasms to lessen IBS symptoms. Techniques like yoga, medication and hypnosis are useful for decreasing stress which  is a common trigger for IBS symptoms.

What are the most popular dietary supplements and vitamins used for IBS

  • Peppermint oil – Peppermint oil (coated capsule or tablet) has an antispasmodic activity similar to the medications belonging to the anticholinergic class. It also demonstrates anti-inflammatory activity and reduces abdominal pain and bloating.

Probiotics – Probiotics contain good bacteria that are usually present in your intestines. These are also found in certain food items like yogurt or nutritional supplements. Probiotics appear to have an anti-inflammatory and pain-reducing effect in people with IBS. Research indicates that probiotics may help decrease IBS symptoms, such as abdominal pain, diarrhea, and bloating.

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