Medications for Irritable Bowel Syndrome

The information provided here is meant to give you a general idea about each of the medicines listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medicines as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Medicines are used to treat specific problems. There are several types of medicines that are thought by some doctors to be helpful. In some cases, your doctor may recommend that you take a combination of medicines.

Prescription Medicines

Antispasmodics

  • Dicyclomine
  • Hyoscyamine
  • Cimetropium—not available in the US

Antidiarrheals

  • Loperamide
  • Eluxadoline

Antidepressants

  • Amitriptyline
  • Paroxetine

5-hydroxytryptamine (5-HT) Antagonists and Agonists

  • Alosetron

Antibiotics

  • Rifaximin
  • Neomycin

Miscellaneous Medicines

  • Lubiprostone

Prescription Medicines    TOP

Antispasmodics

Common names:

  • Dicyclomine
  • Hyoscyamine
  • Cimetropium—not available in the US

These may quiet the digestive system and ease painful bowel spasms. Problems with these are mild when taken as advised.

Some problems are:

  • Dry mouth
  • Nausea
  • Lightheadedness
  • Vomiting
  • Changes in heart rate
  • Urinary retention
  • Visual problems
  • Sexual problems
  • Sleepiness
  • Confusion
  • Itching
  • Rash

Antidiarrheals

Common names:

  • Loperamide
  • Eluxadoline

These slow intestinal activity to ease diarrhea problems.

Some problems are:

  • Dry mouth
  • Nausea or vomiting
  • Bloating or gas
  • Rash
  • Allergic reactions
  • Sleepiness
  • Confusion
  • Lightheadedness
  • Euphoria
  • Drowsiness

Antidepressants

Common names:

  • Amitriptyline
  • Paroxetine

Some antidepressants may lower intestinal spasms. They can be used in those who have depression linked to IBS.

Some problems are:

  • Dry mouth
  • Nausea
  • Lightheadedness
  • Sleep disruption
  • Diarrhea
  • Drowsiness
  • Anxiety
  • Weight loss or weight gain
  • Sexual problems

5-hydroxytryptamine (5-HT) Antagonists and Agonist

Common name: Alosetron

Alosetron is used to treat diarrhea. It can also help with other IBS problems such as belly pain.

Some problems are:

  • Severe constipation
  • Nausea or vomiting
  • Abdominal pain

Antibiotics

Common names:

  • Rifaximin
  • Neomycin

Antibiotics may be used to treat IBS problems such as bloating and diarrhea.

Some problems are:

  • Nausea or vomiting
  • Abdominal pain
  • Fatigue
  • Headache
  • Lightheadedness

Miscellaneous Medicines

Common name: Lubiprostone

This medicine may help those who have constipation as their main problem, but haven't had success using fiber.

Some problems are:

  • Nausea or vomiting
  • Headache
  • Stomach ache
  • Heartburn
  • Diarrhea

Common name: Linaclotide

May be used to increase the amount of fluid in the bowel.

Some problems are:

  • Diarrhea
  • Gas
  • Abdominal pain

Over-the-Counter Medicines    TOP

Fiber Supplements

Common names:

  • Psyllium
  • Bran
  • Polycarbophil
  • Methylcellulose

Fiber comes from plants that can't be digested. They help the intestines work better. They can cause bloating and gas, but these will go away after a few weeks. Slowly increase your fiber intake. Be sure to drink plenty of water when take it. Some types of fiber work better than others. Your doctor will help you find the one that will be most helpful.

Some problems are:

  • Bloating
  • Flatulence

Antidiarrheals

Common names:

  • Loperamide—May cause constipation.
  • Lomotil
  • Bismuth subsalicylate—Soothes the digestive tract without causing constipation. But, it can cause dark stools and a dark tongue.

Antiflatulents

Common name: Simethicone

This will keep gas from getting into the intestines. It breaks up gas bubbles in the stomach, making it easier for it to bring up.

Some problems are:

  • Diarrhea
  • Nausea or vomiting

Probiotics

Common names:

  • Acidophilus
  • Bifidobacterium
  • Lactobacillus
  • Esherichia coli
  • Saccharomyces boulardii

Probiotics are healthy bacteria. They can be found is foods like yogurt or taken as a supplement. It is not very clear which healthy bacteria are best. A blend may be more helpful than just one. Some have found that probiotics may help ease belly pain and other problems of IBS. Talk to your doctor about adding probiotics to your diet.

Gas and bloating are the most common problems. It's often mild and doesn't last long.

Pain Relievers

Common name: Acetaminophen

Acetaminophen may ease belly pain.

Some problems are:

  • Itching
  • Headache
  • Sleepiness

Special Considerations    TOP

If you are taking medicines:

  • Take the medicine as directed. Don’t change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Don’t share your prescription medicine.
  • Medicines can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over-the-counter products and supplements.
  • Plan for refills as needed.

References:

Irritable bowel syndrome (IBS). EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated September 12, 2017. Accessed June 27, 2018.
Irritable bowel syndrome (IBS). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs. Updated November 2017. Accessed June 27, 2018.
Probiotics for irritable bowel syndrome. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated August 11, 2017. Accessed June 27, 2018.
Wilkins T, Pepitone C, Alex B, Schade RR. Diagnosis and management of IBS in adults. Am Fam Physician. 2012;86(5):419-426.
9/18/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Bijkerk CJ, de Wit NJ, Muris JW, et al. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ. 2009;339:b3154.
11/4/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Ford AC, Brandt LJ, Young C, et al. Efficacy of 5-HT3 antagonists and 5-HT4 agonists in irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol. 2009;104(7):1831-1843.
1/11/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Wittmann T, Paradowski L, Ducrotté P, Bueno L, Andro Delestrain MC. Clinical trial: efficacy of alverine citrate/simethicone combination on abdominal pain/discomfort in irritable bowel syndrome: results of a randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2010;31(6):615-624.
2/18/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.
12/24/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Ford AC, Moayyedi P, Lacy BE. American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. Am J Gastroenterol. 2014;109 Suppl 1:S2-26.
Last reviewed May 2017 by EBSCO Medical Review Board Daus Mahnke, MD
Last Updated: 6/27/2018

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