Irritable bowel syndrome (IBS) affects millions of people worldwide with abdominal pain, bloating, gas and diarrhea or constipation.
If you suffer from IBS, you probably want relief. Unfortunately, there’s no cure for IBS, but there are several treatments that can ease the symptoms.
No specific treatment plan is known to be effective in all cases. Lifestyle changes, including a healthy diet, exercise, and stress reduction can be helpful for everyone with IBS. Certain medications may also be used to reduce or eliminate symptoms.
Learn more about various IBS treatments that can relieve your IBS symptoms.
IBS Treatments Overview
While there’s no IBS cure, many patients find symptom relief using one or a combination of these options depending on the type of IBS they have.
Talk to your doctor before trying any new therapy if you’re taking any medications, pre-existing conditions, pregnant, or nursing.
IBS treatment options include:
- Lifestyle Changes – Diet and Exercise
- Herbal Remedies and Supplements
- Therapies – Alternative, Behavioral, Stress Management
1. Lifestyle Changes – Diet and Exercise
The first step towards treating IBS is making lifestyle changes. These steps will improve digestion and reduce inflammation.
Dietary modifications have been shown to improve symptoms in up to 90% of IBS patients.
Keep a food diary of the various foods you eat and the symptoms you experience, so you understand how different types of food affect your body.
This can help to rule out any food allergy or food intolerance, like lactose intolerance causing symptoms.
Here are some common dietary adjustments that have helped people with IBS:
- Low FODMAP Diet – The low FODMAP diet involves avoidance of carbohydrates (sugars) that are poorly absorbed or indigestible by the gastrointestinal tract. High FODMAP foods can lead to bloating and abdominal pain. This diet is very restrictive and not recommended for long term use, but can help you to identify certain high FODMAP foods or groups of foods which trigger symptoms.
- High-Fiber Diet – Eat more fiber. Fiber can cause some bloating and gas when it is first started, so it may help to work your way up to the recommended dose. Insoluble fiber decreases transit time through the gut and can help with constipation. Soluble fiber bulks the stool, giving it more form and consistency and can help with diarrhea.
- Gluten Free Diet – Wheat-containing products like breads and pastas can cause abdominal bloating, gas, and diarrhea. Your doctor may want to test you for Celiac disease. It is important to be on a gluten containing diet for these tests, so if you are considering starting a gluten-free diet, check with your doctor first
- Smaller Meals – Avoid eating too much at once. Eat smaller meals throughout the day instead of three large ones. This helps keep blood sugar levels steady and can help reduce postprandial nausea, bloating and abdominal pain.
- More Water – Drink plenty of water each day. Water helps to keep the digestive tract and bowel function regular. Stool can become hard, lumpy and dry if too much water is reabsorbed from the colon. Fluid intake may help prevent that.
Regular exercise has also proven helpful in reducing IBS symptoms. Aerobic exercises like running, walking, cycling or swimming as well as strength training are both important.
Staying physically fit can help improve constipation and other symptoms as it can improve bowel motility. Core strengthening exercises may reduce bloating and help to flatten a postpartum belly.
Increasing physical activity also helps to reduce stress and improve sleep quality. Getting enough sleep allows your body to recuperate.
How much exercise is needed for better sleep? Engaging in at least 30 minutes of moderate exercise 5 times a week will contribute to a better quality of sleep and improve cardiovascular fitness.
There are several over-the-counter medications (OTC) available to treat mild cases of diarrhea and/or constipation. They may not work well for everyone but can provide temporary relief from symptoms.
For more serious symptoms, your doctor may prescribe medications.
Always talk to your healthcare provider about a medical treatment approach and which OTC or prescription medication might benefit you most.
Read a more in-depth article on IBS medications.
Fiber supplements can help increase transit of stool through the bowel. They are helpful as a first line agent to help with mild constipation or diarrhea.
There are several fiber preparations on the market that come in a variety of formulations including pills, powders and gummies.
Medicine for IBS-C or Chronic Constipation
Laxatives can be useful when treating IBS with constipation. There are a number of Over-The-Counter medication (OTC) and prescription medicines that are used to relieve constipation.
Osmotic laxatives – They help pull fluid into the bowel, which can soften the stool and move stool through the intestine faster. These are OTC options are available:
Stimulant laxatives – They cause the bowel to contract and move stool in the right direction. OTC medications include:
Prescription laxatives – If you are failing with over the counter laxative medications, talk with your doctor about trying a prescription laxative. There are several prescription drugs on the market to help treat constipation, including:
- Linaclotide (Linzess)
- Lubiprostone (Amitiza)
- Plecanatide (Trulance)
- Tegaserod (Zelnorm)
- Prucalopride (Motegrity)
Opioid induced constipation – Opioids have a well known side effect of causing constipation. There are now prescription drugs on the market for treatment of opioid induced constipation, including:
- Naloxegol (Movantik)
- Methylnaltrexone (Relistor)
Suppositories – Suppositories can be inserted into the rectum and held inside for 15-20 minutes until there is a strong urge to defecate.
Enemas – Enemas are used to help irrigate the colon and clean out stool. These are often used in cases of severe constipation or prior to a procedure, like flexible sigmoidoscopy or colonoscopy.
Medications for IBS-D or Chronic Diarrhea
Antidiarrheals slow bowel motility to reduce stool frequency. They can help reduce inflammation and pain associated with diarrhea. There are a number of OTC and prescription medications for care relief of bowel movements.
- Loperamide (Imodium) – OTC
- Rifaxamin (Xifaxan) – Prescription
- Eluxadoline (Viberzi) – Prescription
- Alosetron (Lotronex) – Prescription
Antispasmodics – These are prescription medications which can sometimes help reduce abdominal spasms and cramping.
- Hyoscyamine (Levsin)
- Dicyclomine (Bentyl)
Tricyclic Antidepressants and SSRIs – Since IBS is thought to be a disorder of brain-gut interaction, prescription antidepressant medications, which affect neurotransmitters in the brain, can be used to help modulate pain related to IBS. In some people, this may also help treat their anxiety or depression, but they can be used in patients with no known psychiatric diagnosis.
Bloating and gas are common symptoms that these gas reduction medicines will help with.
3. Herbal Remedies and Supplements
Herbs and supplements are often used to relieve GI distress. Some herbs and supplements have been found to be effective in reducing IBS symptoms. However, there isn’t sufficient evidence yet to prove their effectiveness.
Some herbal remedies and supplements include:
- Fiber – Fiber helps to keep your digestive system healthy by regulating stool form and frequency.
- Peppermint oil – Peppermint oil helps with irritable bowel syndrome by relaxing your muscles in your digestive tract. It also may have an anti-inflammatory effect on your gut lining.
- Herbal teas – Herbal tea helps with IBS by helping to calm your stomach and ease digestion.
- Apple cider vinegar – There are many proponents of using apple cider vinegar for a myriad of GI complaints like heartburn, indigestion, constipation or IBS, but there are no scientific studies proving that it is helpful.
- Ginger – Ginger helps to reduce stomach cramps and gas. Ginger also helps to relieve nausea and vomiting and can be used in pregnant women.
- Milk thistle – There are some studies suggesting that milk thistle may be protective for the liver by antioxidant activity and by reducing inflammation and fibrosis (scar tissue). The current evidence is not strong.
- Probiotics – Probiotics are live microorganisms that aid digestion and promote overall health. Lactobacillus and bifidobacterium are the probiotic strains recommended for good “gut health.” 2 of our favorites are Align and Culturelle. Activia yogurt also contains probiotics.
- Prebiotics – Prebiotics are non-digestible food ingredients that feed probiotic bacteria in the intestines to keep your gut healthy. They can be found in foods like onions, garlic, artichokes, bananas, and whole grains.
Read a more in-depth article on IBS supplements.
4. Therapies – Alternative, Behavioral, Stress Management
These therapies focus on treating underlying causes, rather than just managing symptoms. The goal of treatment is to find ways to prevent flare-ups, so they don’t occur again.
Alternative Therapy Options
Alternative therapies are sometimes considered when conventional medicine and treatments aren’t working or for people who would prefer non-pharmacologic treatment options.
Behavioral Therapy Options
Behavioral therapies (mental health therapy, psychotherapy) with a psychologist or psychiatrist aim to change behavior patterns that cause discomfort. These techniques teach patients how to cope with stressors, which may help reduce IBS symptom frequency and severity.
- Cognitive Behavioral Therapy
- Mindfulness Based Cognitive Therapy
Read a more in-depth article on Behavioral Therapy to treat IBS.
Stress Management Options
Stress can be managed and relieved by taking time out to relax. Some options include:
- Tai Chi
- Deep breathing exercises
- Music therapy
- Art therapy
- Pet therapy
- UCLA Medical School: Mind/Body Psychological Treatments for Irritable Bowel Syndrome
- University of Washing School of Medicine: Complementary and alternative medicine for IBS in adults
- University of Gothenburg, Sweden: Meditation over medication for irritable bowel syndrome?
- Johns Hopkins University School of Medicine: Psychologic considerations in the irritable bowel syndrome
- John Hopkins University School of Medicine: Exercising for Better Sleep
- American College of Gastroenterology: Irritable Bowel Syndrome
- Monash University: FODMAPs and Irritable Bowel Syndrome
- NIDDK: Treatment for Irritable Bowel Syndrome
- NCBI: Milk Thistle: Effects on Liver Disease and Cirrhosis and Clinical Adverse Effects