IBS Treatment Overview
First steps to consider
- It’s important to always see a healthcare provider to get a treatment plan.
- IBS can sometimes be treated at home with OTC medications, diet and lifestyle changes, and natural remedies.
- You may need to see a doctor in-person to get an initial diagnosis and testing.
Call 911 or go to the ER if you have any of the following symptoms:
- You have signs of dehydration (extreme thirst, less frequent urination)
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When to see a healthcare provider
While there are ways to treat symptoms of irritable bowel syndrome (IBS) at home, IBS is a chronic illness that should be managed by a doctor. They can help you control your symptoms and create a comprehensive treatment plan, which may include IBS prescription medication.
Talk therapy may also be recommended to help your symptoms (both pain and bowel function) and also improve your quality of life.
How do doctors diagnose IBS
Your doctor will use specific criteria for IBS to make a diagnosis. These are based on your symptoms, like ongoing abdominal pain and bowel movement patterns. Your doctor will also give you a treatment plan based on which of the three main types of IBS you have.
Your doctor may order tests to check for other conditions that have symptoms similar to IBS. Tests include a colonoscopy, X-ray or CT scan, and an upper endoscopy.
What to expect from your doctor visit
- When diagnosing you, your doctor will make sure you don’t have any other conditions, like celiac disease or irritable bowel disease (IBD).
- If you have IBS, they will use criteria to determine which of the three main types you have: diarrhea-predominant IBS (IBS-D), constipation-predominant IBS (IBS-D), or mixed IBS (IBS-M).
- They’ll also ask you about any medications you’ve been taking to treat your symptoms.
- Your doctor may prescribe medications that target different symptoms, such as bile acid binders, antidepressants, and other medications specifically approved for IBS.
- They may also recommend a type of talk therapy called cognitive behavioral therapy (CBT) to help your symptoms (both pain and bowel function) and also your quality of life.
Prescription IBS medications
- Bile acid binders: cholestyramine (Prevalite), colestipol (Colestid), colesevelam (Welchol)
- Anticholinergics: dicyclomine (Bentyl)
- Tricyclic antidepressants: imipramine (Tofranil), desipramine (Norpramin), nortriptyline (Pamelor)
- SSRI antidepressants: fluoxetine (Prozac), paroxetine (Paxil)
- Pain relievers: pregabalin (Lyrica), gabapentin (Neurontin)
- Alosetron (Lotronex) to relax the colon and slow the movement of waste through the lower bowel
- Eluxadoline (Viberzi) to reduce muscle contractions and fluid secretion in the intestine
- Rifaximin (Xifaxan) to decrease bacterial overgrowth and diarrhea
- Lubiprostone (Amitiza) or Linaclotide (Linzess) to increase fluid secretion in your small intestine to help you pass stool
Types of IBS providers
- A primary care provider can evaluate your symptoms and decide if you need more specialized care.
- A gastroenterologist is a doctor who specializes in the digestive system and can do additional testing and may be more knowledgeable about treatment options.
How to treat IBS at home
You can treat symptoms of irritable bowel syndrome (IBS), like constipation and diarrhea, at home with OTC medications and lifestyle changes.
But even if these treatments help your symptoms, you should always see your healthcare provider if you think you have IBS. They can help you manage your symptoms and create a comprehensive treatment plan.
- OTC medications that can help IBS symptoms include anti-diarrheal medications, constipation treatments, and medications for gas and bloating.
- Trying the low-FODMAP diet can help you avoid foods that commonly cause painful gas.
- Other dietary changes include eating more soluble fiber and not eating foods that can irritate the stomach, like spicy food.
- Lifestyle changes include getting enough sleep and managing stress levels.
- Certain natural remedies may help IBS symptoms. These include probiotics and peppermint oil supplements.
OTC treatments for IBS
- Anti-diarrheal: loperamide (Imodium)
- Bulk fiber laxatives: psyllium (Metamucil), methylcellulose (Citrucel)
- Stool softeners (surfactant laxatives): docusate (Colace), mineral oil
- Osmotic laxatives (hydrating agents): polyethylene glycol (Miralax), magnesium hydroxide (Milk of Magnesia)
- Stimulant laxatives: bisacodyl (Dulcolax), senna (Senokot). You should only take these as needed for a short period of time.
- Probiotics can help balance the stomach’s natural bacteria and help prevent constipation.
How can I manage IBS symptoms at home?
- You may want to try the low-FODMAP diet, an elimination diet that helps you identify and limit or exclude foods that make you gassy, like milk and certain fruits and vegetables.
- Increase the amount of soluble fiber you eat.
- Drinking herbal teas may help symptoms. Peppermint and chamomile tea can help soothe and calm the stomach. Anise tea may help with constipation.
- Apply a heating pad or hot water bottle to your abdomen for stomach pain.
- Avoid spicy foods, heavy meals, and alcohol.
- Stress can trigger physical symptoms, so try to manage your stress levels. Exercise at a moderate intensity 3–5 times a week, get enough sleep (at least 7–8 hours a night), and keep doing activities you enjoy.
- Consider joining a support group. Talking to others with IBS may help you feel less alone and learn about other ways to manage symptoms.