How to treat IBS through medication, diet changes, and mental health care
- You can treat IBS by cutting certain foods out of your diet, balancing your gut bacteria, taking care of your mental health, and taking medication for constipation and diarrhea.
- Following a low-FODMAP diet may help ease your IBS symptoms.
- IBS causes symptoms like bloating, gas, stomach pain, and diarrhea or constipation.
- This article was medically reviewed by Rudolph Bedford, MD, a gastroenterologist at Providence Saint John's Health Center in Santa Monica, California.
Irritable bowel syndrome (IBS) is a digestive tract illness that causes symptoms like stomach pain and diarrhea. IBS is common — about 10 to 15% of Americans struggle with IBS symptoms.
There is no cure for IBS, as it's a chronic condition, but there are several treatments that can help prevent or reduce symptoms. Here's what you need to know about IBS and how to treat it.
What is IBS?
Irritable bowel syndrome affects your large intestine, causing painful and uncomfortable symptoms like bloating, stomach pain, and irregular bowel movements. The exact cause of IBS is not known but experts say there are several factors that play a role, including the strength of your digestive tract muscles and the type of bacteria living in your intestines.
IBS may also have hormonal and genetic factors, as women are twice as likely as men to have IBS, and the condition can run in families.
Irritable bowel syndrome doesn't cause any physical damage to your intestines, but it can interrupt your daily life. For example, people with IBS take three times as many sick days from work compared with workers without IBS.
Symptoms of IBS
Your doctor will usually diagnose you with IBS based on your symptoms. Some common IBS symptoms include:
- Diarrhea or constipation – people often experience one or the other, but some may switch between diarrhea and constipation
- Bloating and excess gas
- Stomach pain or cramping that goes away after you have bowel movement
- Passing mucus in your stool
Treatments for IBS
There are a number of treatments to help you deal with your IBS that range from lifestyle changes to medication. And though these may help you find some relief, there is no cure for IBS that will eliminate the condition entirely.
Cut certain foods out of your diet
No two cases of IBS are the exact same, so keeping a food diary can help you identify which foods trigger your IBS symptoms, says Kara Gross Margolis, MD, a pediatric gastroenterologist, and professor at Columbia University.
"Many people can have an increased severity of IBS symptoms when they eat foods containing wheat, dairy, high gas-producing foods like cabbage or drink carbonated beverages like soda," Margolis says.
Eating certain foods, called FODMAPS (Fermentable Oligosaccharides, Dissacharides, Monosaccharides And Polyols) can also trigger IBS symptoms, says Margolis. This is because people with IBS have a harder time absorbing these foods during digestion, causing fluid to build up in your bowel, Margolis says. FODMAPS can also ferment in your colon, creating excess gas.
You can try following a low-FODMAP diet to help ease your symptoms, which may involve cutting out onions, garlic, gluten, and lactose, along with certain fruits.
In fact, A review published in 2016 in Clinical and Experimental Gastroenterology found that up to 86% of IBS patients see an improvement in their symptoms while following the low-FODMAP diet.
Take care of your mental health
Anxiety and stress can play a big role in IBS. Though stress won't cause IBS, it can make your symptoms more severe. Research shows that taking steps to reduce stress can help prevent or improve symptoms.
One option you can try is cognitive behavioral therapy (CBT), which focuses on changing unhelpful thought patterns and replacing them with productive ways of thinking. A report from 2017 states that CBT "consistently demonstrates significant and durable effects on IBS symptoms and quality of life."
You can also work on your stress levels by "getting adequate sleep, exercising and reducing stressful situations when possible," Margolis says.
Balance your gut bacteria
Some patients may have IBS symptoms caused by an overgrowth of bacteria in the small intestine. Your doctor can determine this using a test that analyzes your breath to detect levels of certain bacteria in your digestive tract.
If you do have a bacterial overgrowth, your doctor may prescribe an antibiotic that specifically targets your intestines. One antibiotic medication is rifaximin (Xifaxin), which can help bring bacteria down to normal levels and decrease diarrhea symptoms.
Take medication to control diarrhea or constipation
If lifestyle and diet changes aren't working to prevent IBS symptoms, you can also try taking over the counter or prescription medications.
For constipation, your over-the-counter options include:
- Psyllium (Metamucil) is a fiber supplement that can help absorb water and bulk up your stool, making it easier to push through your digestive tract.
- Laxatives like polyethylene glycol (Miralax) can help draw water into your colon, making it easier to pass dry, hard stool.
For diarrhea, you can use:
- Loperamide (Imodium) slows down the movement of food through your digestive system and allows water to be absorbed into your body instead of coming out with your stool.
- Cholestyramine (Prevalite) helps to prevent bile acid, an acid produced by your liver to help digest fats, from flowing into your colon. Nearly a third of IBS diarrhea patients have bile acid in their colon, which can cause diarrhea.
If you decide to take medication for IBS, you should first consult a medical professional. "Seeing a doctor is important in determining which medications may be most helpful for your symptoms," Margolis says.
IBS can be a difficult condition to live with, but there are many treatment options available. If you have IBS and develop new symptoms like weight loss, vomiting, and rectal bleeding, or if your IBS symptoms start after the age of 50, you should see your doctor to check for more serious illnesses like colon cancer.
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