Irritable Bowel Syndrome

Medications for Digestive Health Problems

Medications for IBS

Although there is, as of now, no cure for irritable bowel syndrome (IBS), there are many types of medications available that target IBS symptoms. Some of them only address a particular digestive symptom, while newer drugs are coming onto the market that are designed to directly address the overall dysfunction that underlies IBS.

These are the primary medication options that are used to treat a person who has IBS.

Remember that not every drug might be right for you. Which medication your doctor will recommend, if any, will depend on your medical history, the severity of your symptoms, and your predominant bowel problem. Some of these medications are available by prescription only, while others are available over-the-counter. Keep in mind that just because something is available without a prescription does not mean that it appropriate for you.

Be sure to get your doctor's approval before trying something new.

General IBS Medication Options

The following types of medications may be prescribed to anyone who is experiencing IBS, regardless of their specific sub-type. (Keep reading for information about medications that specifically target diarrhea-predominant IBS (IBS-D) and constipation-predominant IBS (IBS-C).

Antispasmodic Medications

Antispasmodic medications are commonly prescribed for IBS, as they can help to relieve the abdominal pain and cramping that is inherent in having IBS. However, they tend to have a constipating effect and, thus, might not be the best choice for a person who has IBS-C.

As research regarding the safety of antispasmodics for long-term use is limited, these medications may be more appropriate for short-term use only. Common antispasmodics prescribed for IBS include:

  • Bentyl (dicyclomine)
  • Buscopan (hyoscine butylbromide)
  • Anaspaz, Cystospaz, Levbid, Levsin (hyoscamine)
  • Mebeverine (not available in the United States)

Antidepressants

Antidepressants are often used at low doses as a way to treat IBS symptoms as they have pain-relieving qualities and are safe for long-term use. Your doctor may recommend an antidepressant even if you are not depressed. If you do have depression or anxiety alongside your IBS, it is even more likely that your doctor may choose this option.

In addition to relieving pain, antidepressants sometimes have side effects that involve digestion. Thus, your doctor may make their choice based on whether you have IBS-C or IBS-D. Available types include the older tricyclic antidepressants (better for IBS-D) or some of the newer options such as the selective serotonin reuptake inhibitors (SSRIs) serotonin-norepinephrine reuptake inhibitors, both of which may be better for IBS-C.

Medication Options for Diarrhea-Predominant IBS

The old standby for diarrhea relief continues to be Imodium (loperamide), which is available over-the-counter. However, two prescription medications have recently received FDA approval for the treatment of IBS-D:

Xifaxan (rifaximin) is an antibiotic that was originally used to treat travelers' diarrhea and small intestinal bacteria overgrowth (SIBO). It's FDA approval is for the treatment of "non-constipation IBS." Xifaxan works differently than most antibiotics as it does not enter into your bloodstream but rather is available to target bacteria in your small and large intestines. It is considered to be safe to use for up to three two-week courses.

Viberzi (eluxadoline) is a medication that affects opioid receptors in your digestive system to relieve the symptoms of abdominal pain and diarrhea for people who have diarrhea-predominant IBS (IBS-D). Because Viberzi is an opiate medication, it is classified as a controlled substance and there are some concerns about a potential for addiction.

Medication Options for Constipation Predominant IBS

Laxatives of all types are commonly used to relieve the symptom of constipation. Miralax (polyethylene glycol), which no longer requires a prescription, is the only one to have been studied by researchers for its effectiveness in reducing IBS symptoms. One study found that it was helpful for easing constipation and softening stools, but not for relieving IBS pain.

There are currently a few prescription medication options for the treatment of IBS-C:

Linzess (linaclotide) works on receptors within the digestive tract to increase the amount of fluid in your large intestine. In addition to IBS-C, Linzess is FDA approved for the treatment of chronic idiopathic constipation (CIC) in adults. In Europe, the medication is called Constella.

Amitiza (lubiprostone) is also FDA approved for the treatment of CIC along with IBS-C. Amitiza targets receptors within the lining of the intestines to release more fluid. Unfortunately, nausea is a fairly frequent and unpleasant side effect of Amitiza.

Resolor/Resotran (prucalopride) is a medication that is only available in Canada and Europe. Resolor works on the neurotransmitter serotonin within the gut and is, therefore, in the same class of medications as Zelnorm, a medication that was taken off the market due to serious side effects. However, Resolor was designed differently so as to avoid those serious complications. As of now, Resolor is only approved by the European Medicines Agency for the treatment of chronic constipation in women.

IBS Medication in the Testing Phase

New medications are coming onto the market, and other possible medication options are going through safety trials. These are the main newcomers; all are in various stages of testing in terms of their safety and effectiveness. Learning about your options can help you work with your doctor to develop an effective treatment plan for your IBS.

Asimadoline is a medication undergoing clinical trials as a treatment for IBS-D. The medication targets very specific receptor sites within the large intestine; it is hoped that such specificity will keep side effects to a minimum. In early trials, it appears that the medication's greatest effect is on easing abdominal pain and discomfort.

Elobixibat is a medication currently being investigated as a treatment for CIC. It works by decreasing the reabsorption of bile acids from the gallbladder, thus increasing the amount of these acids entering your large intestine. This is thought to help to speed up the process of fecal matter through the colon. There is, as of now, no clinical research on elobixibat's effectiveness on IBS-C.

Plecanatide works similarly to Linzess and is currently undergoing clinical trials as a treatment for IBS-C and CIC.

Tenapanor is a medication for kidney disease. It works by reducing the absorption of sodium in the digestive tract; an increase in the amount of sodium is thought to increase the amount of water in the large intestine. Because of this, Tenapanor is currently undergoing clinical trials as a treatment for IBS-C.

A Word From Verywell

Although as you can see there are a variety of medications for IBS, many people who have IBS find that the medication they try is not enough to totally eliminate their symptoms. In some cases, they experience side effects and they have to stop taking the medicine. Luckily, medication is not the only available treatment for IBS. Your other options include over-the-counter remedies, dietary modifications, and psychological therapies. Keep the lines of communication open with your doctor to arrive at the best treatment plan for you.

Sources:

Lacy, B., Chey, W. & Lembo, A. "New and Emerging Treatment Options for Irritable Bowel Syndrome" Gastroenterology & Hepatology 2015 11:1-19.

Lazaraki, G., Chatzimavroudis, G. & Katsinelos, P. "Recent advances in pharmacological treatment of irritable bowel syndrome" World Journal of Gastroenterology 2014 20:8867–8885.

Peyton, L. & Greene, J. "Irritable Bowel Syndrome: Current and Emerging Treatment Options" Pharmacy & Therapeutics 2014 39:567-572, 578.

Tack J, Vanuytsel T, Corsetti M. "Modern Management of Irritable Bowel Syndrome: More Than Motility. " Digestive Diseases 2016;34:566-573.

Trinkley, K. & Nahata M. "Medication Management of Irritable Bowel Syndrome" Digestion 2014 89:253-267.

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