According to Mayo Clinic, mild signs and symptoms can often be controlled by managing stress and by making changes in your diet and lifestyle:
- Avoid meals that make your symptoms worse.
- Consume high-fiber foods.
- Drink a lot of water.
- Exercise on a regular basis
- Get enough rest.
- Food elimination
Your doctor might suggest that you eliminate from your diet:
- High-gas foods. If you have bloating or gas, you may want to avoid carbonated and alcoholic beverages, as well as some foods that cause gas.
- Gluten. Even if they don't have celiac disease, some patients with IBS experience improvement in diarrhea symptoms when they quit consuming gluten (wheat, barley, and rye).
- FODMAPs. Some people are sensitive to FODMAPs – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols — which include fructose, fructans, lactose, and others. Certain cereals, vegetables, fruits, and dairy products contain FODMAPs.
According to Mayo Clinic, your doctor might suggest medications such as:
Fiber supplements. Constipation can be controlled by taking a psyllium (Metamucil) supplement with water.
- Laxatives. If fiber doesn't work, your doctor might suggest over-the-counter laxatives such magnesium hydroxide oral (Phillips' Milk of Magnesia) or polyethylene glycol (Miralax).
- Anti-diarrheal medications. Loperamide (Imodium A-D), an over-the-counter medicine, can help reduce diarrhea. A bile acid binder, such as cholestyramine (Prevalite), colestipol (Colestid), or colesevelam, may also be prescribed by your doctor (Welchol). Bloating can be caused by bile acid binders.
- Anticholinergic medications. Anticholinergic drugs are used to treat a variety of conditions. Painful bowel spasms can be relieved with medications like dicyclomine (Bentyl). They're sometimes given to patients who have diarrhea problems. These drugs are typically safe, although they can induce constipation, dry mouth, and impaired vision in some people.
- Tricyclic antidepressants. This sort of drug can aid with depression as well as alleviate pain by inhibiting the activity of neurons that control the intestines. Your doctor may prescribe a lower-than-normal dose of imipramine (Tofranil), desipramine (Norpramin), or nortriptyline if you experience diarrhea and abdominal pain without depression (Pamelor). Drowsiness, blurred vision, dizziness, and dry mouth are some of the possible side effects, which may be lessened if you take the drug before bed.
- SSRI antidepressants. Antidepressants with selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac, Sarafem) or paroxetine (Paxil), may help if you're sad and suffering from pain and constipation.
- Pain medications. Pregabalin (Lyrica) and gabapentin (Neurontin) are two drugs that can help with extreme pain and bloating.
Medications specifically for IBS
Medications approved for certain people with IBS include:
- Alosetron (Lotronex). Alosetron is a drug that relaxes the colon and slows the passage of waste through the intestines. Alosetron can only be prescribed by doctors who are part of a special program, and it is only approved for use by women with severe diarrhea-predominant IBS who haven't responded to other treatments. It has been associated to a number of rare but serious side effects, therefore it should only be used if other therapies have failed.
- Eluxadoline (Viberzi). Eluxadoline relieves diarrhea by lowering gut muscular spasms and fluid output while also boosting rectum muscle tone. Nausea, stomach pain, and moderate constipation are all possible side effects. Pancreatitis, which can be dangerous and more common in some people, has also been linked to eluxadoline.
- Rifaximin (Xifaxan). Bacterial overgrowth and diarrhea can be reduced using this medication.
- Lubiprostone (Amitiza). Lubiprostone can help with stool movement by increasing fluid secretion in the small intestine. It's approved for IBS with constipation in women, and it's usually only given to women who have severe symptoms that haven't responded to other therapies.
- Linaclotide (Linzess). Linaclotide can also help you pass stool by increasing fluid secretion in your small intestine. Although linaclotide might cause diarrhea, taking it 30 to 60 minutes before eating may help.