It also appears to have anti-inflammatory properties. Rifaximin improves overall IBS-D symptoms. Rifaximin is a global treatment, meaning that it can help multiple IBS symptoms. This drug differs from other IBS-D treatments as it is only taken for 2- weeks. If Rifaximin is beneficial, symptom relief should occur following the 2-week treatment.

Symptoms may return after the initial treatment, and 2 successive treatments are allowed. It is minimally absorbed and generally well tolerated.

The most commonly experienced adverse event is nausea. Serotonin receptors in the GI tract appear to be a good target for treating IBS symptoms. Currently two therapies are FDA approved for the treatment of IBS-C and IBS-D.

More recent studies have shown that rare cases of serious complications of constipation and ischemic colitis may still occur. Despite this, it appears safe when prescribed within a small therapeutic window 0. It should not be used as the first treatment choice in a newly diagnosed patient to treat IBS-D.

Multiple other agents have been tested in small trials for the treatment of IBS. Symptoms are often similar between bile acid malabsorption BAM and IBS-D. Cholesterol is changed into bile acids by the liver. These acids are then absorbed back into the body in the colon.

Sometimes, bile acids are not reabsorbed properly, leading to BAM. Too much bile acid in the colon can result in watery stool, urgency and fecal incontinence. This is why BAM is sometimes called bile acid diarrhea. It has also been evaluated for the treatment of IBS-D.

While less studied, it appears to work like alosetron without the increased risk of severe constipation or ischemic colitis. Pregaballin has been shown to improve pain, bloating and diarrhea symptoms in a small study of IBS patients. These are also being studied for the relief of IBS symptoms.

A recent analysis of 3 studies offered conflicting results. This suggests that the bacteria used, route of administration of the bacteria, and specific IBS subtype may all play a role in symptom response.

Fecal transplants are not currently recommended for treating IBS symptoms. Common Therapies with Proven Efficacy for Global IBS Symptoms Based on Use in Most Common IBS Subtype. By: Darren M. Brenner, MD, Associate Professor of Medicine and Surgery, Northwestern University — Feinberg School of Medicine, Chicago, Illinois; Adapted from an article by: Tony Lembo, MD, Professor, of Medicine and Rebecca Rink MS, Beth Israel Deaconess Medical Center, Harvard Medical School, MA; Edited by: Lin Chang, M.

IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders. Our original content is authored specifically for IFFGD readers, in response to your questions and concerns. If you found this article helpful, please consider supporting IFFGD with a small tax-deductible donation.

During Spring , IFFGD worked with PhD and Public Health student Makenna Lenover to develop IBS Infographic visual content for the aboutibs. org website. Overlap of Fibromyalgia and IBS Fibromyalgia FM is a condition marked by muscle pain all over the body, sleep problems, and fatigue. FM is often.

Any product taken for a therapeutic effect should be considered a drug. Use of medications for IBS, whether prescription, over-the-counter, herbs, or supplements should be. This information is in no way intended to replace the guidance of your doctor.

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Search Close this search box. Medications for IBS. Use of medications for IBS, whether prescription, over-the-counter, herbs, or supplements should be considered carefully and in consultation with your healthcare provider.

Laxatives A laxative is a drug that increases bowel function in patients experiencing constipation. The most commonly used types include: Osmotic — polyethylene glycol PEG such as Miralax® Stimulant — senna cascara, bisacodyl such as Dulcolax®, Correctol® Magnesium-based — milk of magnesia Of these, only PEG has been evaluated in clinical trials in people with IBS-C.

Back to the top. Antidiarrheals These are drugs which slow gut transit. Side effects associated with Loperamide include abdominal pain and constipation which can become severe.

Discontinue use if constipation develops and be sure to contact your healthcare provider. Currently there are 3 FDA approved treatments in this class: lubiprostone, linaclotide, plecanatide, Lubiprostone Amitiza® works through the activation of chloride channels in the bowel. This leads to increased bowel movement frequency.

While the direct mechanism of pain relief is not known, lubiprostone has been proven to relieve overall IBS symptoms in multiple trials. It is currently FDA approved specifically for use in women. This is due to the limited numbers of men that were enrolled in the initial trials.

This drug has proven to be effective in men as well. Common adverse events include nausea and diarrhea. Lubiprostone is also FDA approved for the treatment of chronic idiopathic constipation CIC and opioid induced constipation OIC for people with chronic non-cancer pain related illnesses.

Linaclotide Linzess® and Plecanatide Trulance® work by increasing fluid secretion and gut movement. Both have also been shown to reduce abdominal pain by decreasing activity of pain sensing nerves.

Both drugs treat overall IBS-C symptoms and are FDA approved for the treatment of IBS-C and CIC. Both improve abdominal and stool symptoms within the first week; however, their maximum effect on pain can take longer to appear.

The most common side effect experienced by people taking linaclotide or plecanatide is diarrhea. These drugs work mainly in the GI tract and have a minimal effect on the whole body. This means that there is minimal risk of interactions between it and other drugs.

Antispasmodics Antispasmodics are drugs which suppresses smooth muscle contractions in the GI tract. There are three major classes of antispasmodics: anticholinergics, direct smooth muscle relaxants, and peppermint oil. Because symptoms of IBS tend to be worse after eating, taking these medications 30 to 60 minutes before a meal may help prevent symptoms.

There are two types of antispasmodic medications used for IBS: anticholinergics and direct smooth muscle relaxants. Peppermint oil also has antispasmodic properties and is sometimes used. Anticholinergics are a type of antispasmodic designed to block the neurotransmitter acetylcholine.

This is a chemical produced by the body that acts on the autonomic nervous system , the part of the nervous system associated with involuntary functions.

Anticholinergics stop cell signals that contract muscles in the digestive tract, heart, lungs, and urinary tract. In addition to IBS, they're used for conditions including pancreatitis , asthma , chronic obstructive pulmonary disorder COPD , and Parkinson's disease.

By blocking acetylcholine receptors in the digestive tract, anticholinergics can slow digestion, decrease the severity of muscle spasms, and reduce the overproduction of mucus. Examples of commonly prescribed anticholinergics include:.

Anticholinergics can affect organ systems beyond the digestive tract, triggering side effects such as:. Due to the risk of constipation, these antispasmodics are best used in cases of diarrhea-predominant IBS IBS-D rather than constipation-predominant IBS IBS-C.

Some older studies suggest drugs like Buscopan are effective in treating IBS. However, the clinical guidance from the American College of Gastroenterology ACG recommends the use of other agents instead, including neuromodulators and chloride channel activators like Amitiza lubiprostone. A class of drugs called direct smooth muscle relaxants, which are synthetic anticholinergics, appear to be more effective at treating IBS than regular anticholinergics.

These drugs also have fewer problems with side effects. However, these antispasmodics aren't currently FDA-approved for any use in the United States. Medications available in other countries include:.

These drugs work by altering the transportation of sodium and calcium. Direct smooth muscle relaxants affect the smooth muscle of the digestive tract only.

They're only used for IBS and intestinal cramping. Direct smooth muscle relaxants very rarely have reports of side effects. When they are reported, common ones appear to be:. You shouldn't take this type of antispasmodic if you have paralytic ileus , a nerve condition that affects digestion.

Direct smooth muscle relaxants should be used with caution in:. Peppermint oil is an over-the-counter OTC natural antispasmodic. It contains menthol, a substance that scientists believe relaxes smooth muscle by operating on calcium channels in smooth muscle cells in the gut.

Some prescription calcium channel blockers are used similarly to treat high blood pressure hypertension and other cardiovascular disorders , because they relax smooth muscles in the blood vessels. Peppermint oil is used for IBS, other digestive problems, and to treat sinus infections and headaches.

Most of the research into the medicinal uses of peppermint oil has been related to IBS. A review of studies by researchers at the University of California, San Diego concluded that persons with IBS symptoms were nearly three times more likely to achieve relief with peppermint oil than with a placebo.

While considered safe for short-term use, peppermint oil is known to cause heartburn in some people. To avoid this side effect, you can use enteric-coated capsules. Their coating doesn't dissolve until it's farther along in the digestive system, which prevents irritation.

This natural antispasmodic should be used with caution if you have:. Be sure to consult your healthcare provider before taking peppermint oil or any other OTC supplement.

The American College of Gastroenterology recommends peppermint oil for its antispasmodic properties. They also suspect that peppermint exerts direct antimicrobial effects and anti-inflammatory effects, and may help with feelings of distress caused by IBS.

Certain people should avoid antispasmodic drugs. You shouldn't take anticholinergics if you're older than 65, pregnant or breastfeeding, or if you have:.

In addition to antispasmodic medications, dietary changes can also significantly improve IBS symptoms. Depending on the symptoms you're experiencing, you may want to:. Limiting foods that contain lactose, fructose, or FODMAPs fermentable oligosaccharides , disaccharides, monosaccharides, and polyols may offer benefits when managing IBS symptoms.

Treatments for irritable bowel syndrome IBS may include antispasmodic drugs that work to prevent spasms in the smooth muscle of your digestive tract. Reducing the spasms can improve symptoms including abdominal pain and bloating, especially in people with diarrhea related to IBS-D. Anticholinergics and direct smooth muscle relaxants, along with peppermint oil, may offer benefits.

This may be partly due to the alleviation of an underlying depression and partly because of a direct effect on pain pathways in the gut. Anxiety and depression can make people more sensitive to pain and can upset the bowels. Antidepressants can only be obtained on prescription. To Read More Join today to access Members' Exclusive Content Join Login Donate.

Web Design - Rejuvenate Digital Agency. Join Today. Sign-in Contact Search. Home About Us Self Care Programme Back Self Care Programme Have I Got IBS? Back Have I Got IBS? What is IBS? Could it be anything else?

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FODMAPS So what can I eat?

Two authors independently extracted data from the selected studies. A proof of practice analysis was conducted including sub-group analyses for different types of bulking agents, spasmolytic agents or antidepressant medication. This was followed by a proof of principle analysis where only the studies with adequate allocation concealment were included.

A total of 56 studies patients were included in this review. These included 12 studies of bulking agents patients , 29 of antispasmodics patients , and 15 of antidepressants patients.

The risk of bias was low for most items. However, selection bias is unclear for many of the included studies because the methods used for randomization and allocation concealment were not described. No beneficial effect for bulking agents over placebo was found for improvement of abdominal pain 4 studies; patients; SMD 0.

Subgroup analyses for insoluble and soluble fibres also showed no statistically significant benefit. Separate analysis of the studies with adequate concealment of allocation did not change these results.

Separate analysis of the studies with adequate allocation concealment found a significant benefit for improvement of abdominal pain. Subgroup analyses showed a statistically significant benefit for selective serotonin releasing inhibitors SSRIs for improvement of global assessment and for tricyclic antidepressants TCAs for improvement of abdominal pain and symptom score.

Separate analysis of studies with adequate allocation concealment found a significant benefit for improvement of symptom score and global assessment. Adverse events were not assessed as an outcome in this review. Language: English Español Français Hrvatski 日本語.

If you found this evidence helpful, please consider donating to Cochrane. We are a charity that produces accessible evidence to help people make health and care decisions.

Authors' conclusions:. Search strategy:. Selection criteria:. Data collection and analysis:. Main results:. Health topics:. IBS flares can last hours to weeks. You can try these…. Irritable bowel syndrome is a chronic condition that affects the gastrointestinal GI tract.

Post-infectious IBS happens when a person suddenly…. A Quiz for Teens Are You a Workaholic? How Well Do You Sleep?

Health Conditions Discover Plan Connect. Inflammatory Bowel Disease. How Antispasmodics Provide Relief for IBS Symptoms.

Medically reviewed by Philip Ngo, PharmD — By James Roland on February 22, Antispasmodics Types Side effects Pros and cons When not to take Other treatments FAQ Takeaway Antispasmodics help relieve gut spasms and cramps associated with irritable bowel syndrome.

How effective are antispasmodics for treating IBS? What are the types of antispasmodics for treating IBS? What are the side effects of antispasmodics for treating IBS? What are the pros and cons of using antispasmodics for treating IBS?

Benefits of antispasmodics for treating IBS They are generally well tolerated and can be taken by most people. They can be taken before meals to easily time them to be most effective when post-meal symptoms begin.

They can cause many kinds of side effects, some of which can be worse than IBS symptoms. They may take up to an hour to relieve symptoms. Was this helpful? Who should not take antispasmodics for treating IBS?

Are there other treatments for IBS? Frequently asked questions. The takeaway. How we reviewed this article: Sources. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations.

We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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