Irritable Bowel Syndrome (IBS)
Medications
Medication may be used along with lifestyle changes to manage symptoms of irritable bowel syndrome (IBS).
The goal of medication 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. Medications may be prescribed to treat moderate to severe pain, diarrhea, or constipation that does not respond to home treatment. No single medication has been shown to be effective in relieving IBS over the long term.
Antidepressant medications may improve IBS symptoms even in people who do not have depression, especially the medication class known as tricyclic antidepressants. Anti-anxiety medications may help if anxiety contributes to your IBS symptoms.
Medication Choices
In most cases, the choice of medication 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
Medications that may be used to treat severe diarrhea that does not improve with home treatment include:
- Antidiarrheals, such as diphenoxylate (Lomotil) and loperamide (Imodium), which slow intestinal movements.
- Bile acid binding agents (cholestyramine), which prevent bile acids from stimulating the colon, slowing the passage of stools and relieving diarrhea.
- Anticholinergics (antispasmodics), such as dicyclomine (Bentylol), which help prevent or relieve painful cramping spasms in the intestines.
For pain with anxiety or depression
The following medications may be used if long-term (chronic) pain also occurs with anxiety or depression:
Other
Additional medications are being studied to treat IBS. Some are not yet available for use in Canada. Medications to relax smooth muscle to reduce abdominal pain and bloating include darifenacin, pinaverium, and trimebutine. Trimebutine is available in Canada; both pinaverium and trimebutine are available in Europe.
What To Think About
Since few medications have proven consistently helpful and because all medications have side effects, medication should be used for specific symptoms that disrupt your normal daily activities.
If you also have another illness, such as depression, that triggers symptoms of irritable bowel syndrome, medication treatment for that illness may be needed.
Advisory. Health Canada and the U.S. Food and Drug Administration (FDA) have issued advisories to patients, families, and health professionals to closely monitor adults and children taking antidepressants for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.
Health Canada and the FDA also advise that patients be observed for increases in anxiety, panic attacks, agitation, irritability, insomnia, impulsivity, hostility, and mania. It is most important to watch for these behaviours in children, who may be less able to control their impulsivity as much as adults and therefore may be at greater risk for suicidal impulses. Health Canada and the FDA have not recommended that people stop using antidepressants, but simply to monitor those taking the medications and, if concerns arise, to contact a health professional.
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| Author: | Carrie Henley Robin Parks, MS | Last Updated: August 22, 2006 |
| Medical Review: | Kathleen Romito, MD - Family Medicine Tom Bailey, MD - Family Medicine Arvydas D. Vanagunas, MD - Gastroenterology | |
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