Digestive Health Irritable Bowel Syndrome Treatment Print How IBS Is Treated Medically reviewed by Medically reviewed by Andy Miller, MD on June 07, 2019 Andy Miller, MD, is board-certified in internal medicine and infectious disease by the American Board of Internal Medicine. Learn about our Medical Review Board Andy Miller, MD Written by twitter Written by Barbara Bolen, PhD Barbara Bolen PhD helps people live with irritable bowel syndrome by offering awareness on the mind and body connection, and she has written multiple books on the topic. Dr. Bolen is also a licensed clinical psychologist and health coach. Learn about our editorial policy Barbara Bolen, PhD Updated on July 17, 2019 Irritable Bowel Syndrome Overview Symptoms Causes Diagnosis Treatment Coping Nutrition In This Article Table of Contents Expand Diet Over-the-Counter (OTC) Therapies Prescriptions Specialist-Driven Therapies View All Irritable bowel syndrome (IBS) treatment does not readily fit into a "one-size-fits-all" plan. Working with your physician, and with a little trial and error, you can find your own path for managing your symptoms. This will likely require a multi-faceted approach, which might include prescription or over-the-counter medication, lifestyle changes, and even psychotherapy. If you haven't already done so, it is essential that you see a doctor to discuss any ongoing digestive symptoms you may be having—even if you've been diagnosed with IBS and are following a recommended treatment plan to the letter. In the event your condition has changed, your treatment approach must evolve as well. Diet The simple act of eating—large or fatty meals, in particular—can stimulate bowel contractions. As such, changing eating habits is one of the most common ways that individuals manage their IBS. Diet Restriction A food diary can help you track what you eat and how it makes you feel. If you notice that your symptoms tend to flair after eating a certain food, consider eliminating that food (and similar ones) for a period of about three months to see if this has any effect on your IBS. If not, try eating the food again and repeat the process with the next food on your list. Common food and drink culprits include: Fatty foodsGas-producing vegetablesCarbonated drinksArtificial sweetenersCaffeineAlcohol Note, however, that what affects your IBS can be somewhat unpredictable. Stress and hormonal changes also contribute to IBS symptoms. Because of this, a food that is poorly tolerated on one occasion may be enjoyed without consequence on another. Consider seeking the advice of a nutritionist who can help identify other problematic foods and ensure that your diet is balanced, despite it being restricted. In addition to the above changes, you may also consider an elimination diet to rule out lactose intolerance or fructose malabsorption. The Low-FODMAP Diet FODMAP stands for fermentable oligo-, di-, monosaccharides, and polyols. These carbohydrates can be particularly problematic for people with IBS because they compound the very issues those with the condition struggle with (i.e., gas, bloating, abdominal pain, diarrhea, and constipation). Following the low-FODMAP diet can be challenging, but it has some sound research support for its effectiveness. The diet involves eliminating these carbohydrates from your diet for a period of six to eight weeks and then gradually adding them back into your diet to assess for tolerance. Learn How the Low-FODMAP Diet Can Help IBS Fiber Fiber is generally recommended due to its many health benefits and its ability to help soften and firm up stool. However, it is best to add fiber slowly to allow your body time to adjust. There is also some evidence that soluble fiber is better tolerated by people who have IBS. Meal Size and Timing To ease the stress on your digestive system, it's recommended that you eat smaller, more frequent meals instead of the traditional three big ones. That said, for constipation, a large breakfast may help encourage intestinal contractions and the urge to have a bowel movement. Over-the-Counter (OTC) Therapies There are a wide variety of OTCs used to address digestive symptoms. While you can access these without a prescription, it's best to check with your doctor before using any OTC product for IBS. A few of the more commonly used OTC drug options include: Imodium: Helpful for easing diarrhea, but not necessarily IBS painLaxatives such as Miralax, Metamucil, Benefiber, and CitrucelProbiotic supplements: These contain live strains of "friendly bacteria." Prescriptions Traditionally, medication options for IBS have been limited. Luckily, that situation is changing rapidly as new medications are being developed. Here are some of the prescription options that are currently available. Antispasmodics Antispasmodics are the most frequently prescribed medications for IBS as they help to ease symptoms of abdominal pain and cramping, particularly for people who have diarrhea-predominant IBS (IBS-D). Examples of antispasmodics that may be prescribed for IBS include: Bentyl (dicyclomine)Buscopan (hyoscine butylbromide)Levsin (hyoscyamine) Antispasmodics work best if taken 30 to 60 minutes prior to eating and may be better at providing short-term, as opposed to long-term, relief of symptoms. Antispasmodics for IBS IBS-Specific Medications While antispasmodics can be effective, they are used for several conditions, not just IBS. To provide even more targeted relief, pharmaceutical companies have been working to develop medications for treating IBS specifically, with several new options coming onto the market over the past few years. These medications typically work on receptors within the large intestine to bring about IBS symptom relief. Options for the treatment of constipation-predominant IBS (IBS-C) include: Linzess, Constella (linaclotide)Amitiza (lubiprostone) And for the treatment of IBS-D: Viberzi (eluxadoline) Antibiotics People are often surprised when they hear that antibiotics may be prescribed for IBS, as taking a round of antibiotics can often make IBS symptoms worse. However, the specific antibiotics used to treat IBS are not absorbed in your stomach. Rather, they target bacteria in your small and large intestine. Of this class, only Xifaxan (rifaximin)—used for the treatment of non-constipation IBS—has U.S. Food and Drug Administration (FDA) approval. Antidepressants Antidepressant medications can affect the functioning of your digestive system. Your doctor may opt for one for several reasons, the most common of which is that these drugs can safely be taken for a long period of time—an advantage for a chronic disorder like IBS. Doctors are more likely to recommend an antidepressant to you if your symptoms have not been addressed through lifestyle and dietary modifications, and if you also experience depression and/or anxiety alongside your IBS. Antidepressants used to treat IBS include both the selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants. Both classes of medications are thought to have pain-reducing qualities. Your doctor may choose which type of antidepressant to give you based on your predominant bowel problem (i.e., constipation or diarrhea), as different antidepressants have different effects on stool formation and bowel movement frequency. The Link Between IBS and Depression Specialist-Driven Therapies A variety of psychological therapies have been studied for their effectiveness in reducing the frequency, intensity, and duration of IBS symptoms, including cognitive behavioral therapy (CBT), hypnotherapy, stress management approaches, and relaxation exercises. CBT and gut-directed hypnotherapy have the most solid research support for their effectiveness in reducing IBS symptoms. CBT is a form of psychotherapy in which you are taught strategies for modifying maladaptive thinking patterns, as well as new behaviors for managing anxiety and handling stressful situations. Hypnotherapy involves the induction of a relaxing and comfortable state of consciousness in which specific suggestions are offered in order to lead to a permanent change in behavior. Stress and anxiety play a complex role in IBS that researchers are still sorting out. But keeping both in check has been proven to help reduce IBS symptoms. Psychological therapies offer the advantage of helping you to learn long-term strategies for handling your IBS without the risk of possible negative side effects associated with medication. Complementary Alternative Medicine (CAM) Studies have shown that enteric-coated peppermint oil has strong antispasmodic qualities and, thus, may be effective in easing IBS pain. There are a variety of other herbal supplements thought to be good for overall digestive health and the management of digestive symptoms as well. Coping and Living Well With IBS Was this page helpful? Thanks for your feedback! One of the most challenging aspects of having IBS is trying to figure out what's safe to eat. Our recipe guide makes it easier. Sign up and get yours now! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Health Essentials. Cleveland Clinic. Best and Worst Foods for IBS. 2014. Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014;20(39):14126-31. doi:10.3748/wjg.v20.i39.14126 Böhn L, Störsrud S, Liljebo T, et al. Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trial. Gastroenterology. 2015;149(6):1399-1407.e2. doi:10.1053/j.gastro.2015.07.054 El-salhy M, Ystad SO, Mazzawi T, Gundersen D. Dietary fiber in irritable bowel syndrome (Review). Int J Mol Med. 2017;40(3):607-613. doi:10.3892/ijmm.2017.3072 Camilleri M, Ford AC. Pharmacotherapy for Irritable Bowel Syndrome. J Clin Med. 2017;6(11):101. doi:10.3390/jcm6110101 Kinsinger SW. Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights. Psychol Res Behav Manag. 2017;10:231-237. doi:10.2147/PRBM.S120817 Additional Reading Foxx-Orenstein, AE. New and emerging therapies for the treatment of irritable bowel syndrome: an update for gastroenterologists.Therapeutic Advances in Gastroenterology. 2016;9:354–375. doi: 10.1177/1756283X16633050 Tack J, Vanuytsel T, Corsetti M. Modern Management of Irritable Bowel Syndrome: More Than Motility. Digestive Diseases. 2016;34:566-573. doi: 10.1159/000445265 Continue Reading