If dietary changes don’t relieve the symptoms of irritable bowel syndrome, or IBS, your NYU Langone physician may prescribe one or more medications to treat the condition. Our gastroenterologists focus on relieving the symptoms that most interfere with your quality of life.
People experience diarrhea when the body doesn’t absorb enough water from food passing through the intestines. This results in frequent bowel movements to eliminate stool containing excess water.
If diarrhea is your predominant symptom, your doctor may recommend an antidiarrheal medication. These medications help slow digestion, allowing the intestines to absorb more water from stool before it passes out of the body. However, they can cause constipation if they’re taken too frequently.
Antidiarrheal medications are available over the counter or by prescription.
Laxatives and stool softeners are used to relieve constipation, which occurs if bowel movements are too infrequent or difficult to pass. With hard stools, you may experience cramping and abdominal pain. The same is true of infrequent bowel movements. When bowel movements do occur, the stool may be overly firm and difficult to pass, resulting in straining.
Your doctor may recommend taking an over-the-counter laxative or stool softener, which can increase the amount of water in stool to help it pass more easily.
If you have a bowel movement once a week or less, doctors may prescribe a more powerful laxative to stimulate the digestive system. Sometimes, these medications can cause diarrhea or abdominal cramping.
Abdominal pain and bloating are common symptoms of IBS and may occur along with diarrhea, constipation, or both. Some people find that abdominal pain—which may feel like a deep, aching pain similar to stomach cramps or a sharp, stabbing pain—is the most difficult symptom of IBS. Our physicians can recommend one or more medications to relieve the pain.
For abdominal pain associated with IBS, your physician may recommend a prescription antispasmodic medication to relax the gut muscles, easing pain and discomfort.
Some research suggests that peppermint oil—an extract available at health food stores—may act as a natural antispasmodic agent. Your doctor can determine whether peppermint oil is right for you.
Probiotics are dietary supplements that contain beneficial microorganisms already found in the gastrointestinal tract. If the body’s “good” bacteria become outnumbered by “bad” bacteria as a result of IBS, the digestive system’s microbacterial environment—or gut microbiome—becomes unbalanced. A bacterial imbalance can lead to gas, bloating, and irregular bowel movements.
For some people, probiotic supplements may help restore the right balance of “good” and “bad” bacteria. The dosage varies depending on the type of supplement your physician recommends. Researchers at NYU Langone are leading the way in evaluating the role of the gut microbiome in preventing and treating digestive diseases.
Your doctor may recommend nonabsorbable antibiotics, such as rifaximin, if the results of a hydrogen breath test indicate that you have an overgrowth of bacteria in the intestines. This type of medication is prescribed to target bacteria that cause gas, bloating, and other IBS symptoms.
Unlike other antibiotics, nonabsorbable antibiotics are not absorbed into the bloodstream and body, allowing them to target intestinal bacteria.
Your physician may prescribe this medication, which is taken by mouth, for about 10 days.
When prescribed in low doses, some antidepressant medications may block pain signals that travel between the digestive system and the brain, alleviating abdominal pain. These include tricyclic antidepressants, serotonin–norepinephrine reuptake inhibitors, and selective serotonin reuptake inhibitors.
Even when taken in low doses, these medications may have side effects, including weight gain and mood swings. So it is important that you and your physician schedule regular follow-up appointments to determine the dosage of medication that relieves IBS symptoms without causing side effects.