B) Medications
IBS medications treat one symptom or more. Thus, the predominant symptom should be taken into consideration to determine what kind of drugs should be taken. It is advisable to consult a physician or GP (general practitioner) before taking OTC (without prescription) drugs. Classifying drugs according to their action:
1. Antispasmodic / anticholinergic drugs, such as:
Dicyclomine (Bentyl)
Dicyclomine (Bentyl) which is a recommendable smooth muscle relaxant which helps reduce colic pain and intestinal spasms.
Hyoscyamine (Levsin)
Hyoscyamine (Levsin) which is also well-known for its extensive uses, including relieving colic pain and enhancing the motility of the gut.
- Dosage of both differs according to the condition and the age of the patient, so make sure to consult a doctor or healthcare provider before taking them.
- Side effects of both include dizziness, headache, blurred vision and nervousness. They are commonly reported, but no considered serious complications.
2. Antibiotic drugs such as Xifaxan (Rifaximin):
It is a well-reputed antibiotic that is usually used in IBS-D (irritable bowel syndrome with diarrhea) to alter or kill harmful intestinal bacteria. It is also believed that a two-week course of Rifaximin would help the patient gets better. Rifaximin, like many antibiotics, is relatively expensive, so it isn’t the first medication doctors recommend or prescribe.
- Dosage: three 550 mg tablets daily is the standard dose of Xifaxan or as prescribed by your physician.
- Side effects: nausea, vomiting, abdominal pain, and bloating.
3. IBS drugs (for overall symptoms) such as:
Alosetron (Lotronex)
It reduces the severity of the symptoms and relieves pain significantly as it blocks pain signals discharged from the gut to the brain. Although Lotronex efficacy is reported to be higher in IBS-D, it isn’t prescribed for children because of serious complications that may possibly arise.
- Dosage: twice a day is the standard dose.
- Side effect: headache, haemorrhoids, nausea and bloating may happen.
Always share with your doctor any other symptoms.
Lubiprostone (Amitiza )
Lubiprostone (Amitiza ) uses are various. It is helpful to treat chronic constipation as it primarily improves intestinal motility and help the intestines contract and relax in harmony with a specific pace. It is thought that Amitiza enhances the secretory function of the intestines and improves the overall condition of the patient. It is mostly prescribed to patients with IBS-C (irritable bowel syndrome with constipation).
- Dosage: differs according to the severity of symptoms.
- Side effects: A runny nose, nausea and vomiting.
4. Probiotic products:
Probiotic products containing bifidobacterium or lactobacillus claim to be the ideal solution for irritable bowel syndrome as they reinforce the intestinal healthy bacteria, which will lead to proper digestion and excretion and subsequently reducing bowel bad habits. Align is one of the most well reputed company for probiotics.
5. Laxatives such as:
Polyethylene glycol (MiraLAX)
Polyethylene glycol (MiraLAX) is an osmotic laxative that could relieve constipation as it keeps hydrophilic compounds in the intestine so that water stays in the gut to stimulate the intestinal motility and ease stool passage through the intestines.
- Dosage: once daily is the standard dose for up to one week. Any further usage should be under a doctor’s supervision.
Lactulose (Enulose)
Lactulose (Enulose) is a well-known laxative which works as well as other as osmotic laxatives.
- Dosage: 2-3 tablespoons per day is usually enough to soften your stool. If this dose doesn’t help, consult your doctor before increasing it.
- Side effects of both: nausea, bloating, vomiting and diarrhoea.
Bisacodyl (Dulcolax)
Bisacodyl (Dulcolax) is a stimulant laxative that enhances intestinal motility and improves its secretion which eases the defecation process and relieves constipation. Dulcolax is believed to have active ingredients causing a fast response within 10 -15 minutes.
- Dosage: twice a day is the frequent dose with no more intake after one week without the supervision of a doctor.
- Side effects: nausea, vertigo and vomiting.
6. Anti-diarrheal drugs such as:
Loperamide (Imodium)
Loperamide (Imodium) is an OTC drug that enhances intestinal water absorption with remarkable efficiency.
- Dosage: two (2mg) capsules per day is a typical dosage. It is reported that misuse of Imodium causes severe complications and may lead to death.
- Side effects: dry mouth, fatigue, dizziness and vomiting.
7. Anti-flatulence drugs such as:
Simethicone (Mylicon)
Simethicone (Mylicon) is made for patients who suffer from bloating and intestinal flatulence as it reduces the gas bubbles in the gut relieving the associated discomfort. Mylicon feedback is promising so it is usually prescribed by physicians and paediatrics.
- Dosage: 3 times after meals per day is usually enough to eliminate bloating.
- Side effects: trouble breathing, dizziness and itching.
8. Anti-histamine drugs:
The action of this kind of medications towards irritable bowel syndrome is still under research. Thus, it is not preferable to start IBS treatment with them.
Theoretically, anti-histamines inhibit and block histamine action, which already has formed the inflammatory tissue causing irritable bowel syndrome.
Claritin and Zyrtec
Claritin and Zyrtec are claimed to relieve most of the symptoms in IBS.
- Their dosage: as told by the doctor.
- Side effects: blurred vision and abdominal cramps.
9. Antidepressant drugs:
A significant portion of patients who suffer from IBS face emotional distress and anxiety, so sometimes antidepressants should be prescribed to these patients to treat depression. Antidepressants should be taken only if none of the previously mentioned treatments helped the patient get better.
- IBS-C antidepressants are usually called SSRI (selective serotonin
Receptor inhibitors) such as Zoloft, Celexa and Paxil. - IBS-D antidepressants are often tricyclic which are known for their more possible serious side effects than SSRI such as Imipramine (Tofranil) and Desipramine (Nopramin).
