Irritable Bowel Syndrome (IBS) is a disease of the gastrointestinal system that causes altered bowel habits and abdominal discomfort, if not associated with any other disease. It is the most commonly diagnosed gastrointestinal disease in primary care hospitals. Even so, many IBS cases go undetected due to various socio-economic reasons. Many cases of IBS in females present with abdominal pain and constipation, while in males it is associated with diarrhoea. Broadly IBS can be categorised as IBS with diarrhoea (IBS-D), IBS with constipation (IBS-C), and IBS with mixed pattern (IBS-M). IBS is manageable through changes in food habits and certain medicines.
Treatment of Irritable Bowel Syndrome (IBS)
The indications of IBS vary depending upon the underlying cause and the treatment given is subjective to the symptoms experienced. The treatment includes both medicines and some non-pharmaceutical approaches, particularly for mild cases. Nonetheless, the IBS treatment given should be personalised and must consider the patient’s health status and medical background. Treatments are given to reduce symptoms such as abdominal pain, constipation, diarrhoea, bloating, cramping, etc. With the required individualised treatment approach the symptoms can be managed and the quality of life of the patients can be
Commonly practiced irritable bowel syndrome treatments are:
Non-pharmaceutical approaches
- For IBS-C, fiber supplements, and herbal laxatives are recommended to reduce the problem.
- Whereas, in the case of IBS-D, a probiotic is given as a supplement.
Pharmaceutical approaches
- Magnesium hydroxide oral (Phillips' Milk of Magnesia) or polyethylene glycol (Miralax) are recommended as laxatives for IBS-C patients.
- Loperamide is given to IBS-D patients to treat diarrhoea
- Psyllium (Metamucil) helps to reduce IBS-C symptoms
- Many anti-diarrheal, anti-constipation, and anti-cholinergic medicines like tricyclic antidepressants, antipsychotics, serotonin reuptake inhibitors (SSRIs) and diphenhydramine have a wide range of actions including on smooth muscle located in the Gastro-Intestinal tract to reduce the symptoms of IBS.
- Analgesics or pain medicines are given to reduce abdominal pain
- Certain drugs particularly recommended for IBS patients are –
- Rifaximin: reduces abdominal pain and diarrhoea
- Alosetron (Lotronex): Used to treat IBS-D in females
- Eluxadoline (Viberzi): Reduces muscle contraction and secretions in the intestine
Physical activity
- Enhanced physical activity can help improve the symptoms by increasing the transit time of food through the colon.
- Reducing the intake of FODMAPs – FODMAPs refer to fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are present in foods like wheat products, onions, certain fruits and vegetables, sorbitol, and some dairy. FODMAPs are known to increase abdominal pain and gastrointestinal symptoms in IBS patients.