Irritable bowel syndrome (IBS), also known as “spastic colon,” is a surprisingly common disorder. Over 14% of Americans suffer from this disorder, which is characterized by chronic digestive problems like diarrhea, constipation, and abdominal pain. No one is sure what causes irritable bowel syndrome, but there are medications available that can help control its symptoms. There are several different subtypes of the disorder, which often respond well to different types of IBS medication. Irritable bowel syndrome cannot be cured completely, so the goal for successful treatment is to reduce its characteristic symptoms like constipation, diarrhea, and abdominal pain. This is often achieved using a combination of medicine for IBS, dietary alterations, and stress reduction.
What Are The Symptoms of IBS?
Irritable bowel syndrome can present in different ways. The most common symptoms of IBS include:
● abdominal pain
● abnormal urgency of bowel movements
● feeling of incomplete evacuation (tenesmus)
● blood in stool
● acid reflux
● chronic fatigue
● psychological symptoms like depression and anxiety
There are three main subtypes of irritable bowel syndrome. It can be diarrhea-predominant (IBS-D), constipation predominant (IBS-C), alternate between diarrhea and constipation (IBS-A), or the main symptom can be abdominal pain and discomfort.
There isn’t a specific test that is used to diagnose someone with irritable bowel syndrome. It’s diagnosed based on its symptoms. The physician must also rule out other conditions. They might do some tests to rule out other possibilities like colon cancer, microscopic colitis, or gastroenteritis. These tests often include:
● Stool microscopy, to check for microbe infections
● Blood tests, including testing for coeliac disease
● Abdominal ultrasound, which checks for gallstones
● Endoscopies and biopsies to look for ulcers or malignant growths
● Hydrogen breath testing, to make sure your body is absorbing sugars like glucose and fructose correctly.
When these tests come up negative, it often indicates that the correct diagnosis is irritable bowel syndrome. IBS is a very common diagnosis, but it’s still important to rule out other, potentially more serious issues that can cause similar symptoms.
What Causes IBS, and How Does IBS Medication Help?
The exact causes of irritable bowel syndrome are not clear. It’s been shown that the condition can run in families, but no one is sure of the exact genetic cause. There are two main factors that appear to be involved in IBS: the communication pathways between the brain and the digestive tract, and bacterial flora. Bacterial flora are the necessary microbes that live inside the human digestive system. Recent research has produced some evidence that people with IBS, especially the diarrhea-predominant type, have abnormally low levels of a certain type of bacteria, Bacteroidetes. This appears to be because these people produce too many antibodies that attack these beneficial bacteria, which contributes to chronic inflammation in the tissues of the digestive organs.
Although the exact causes of IBS are still be investigated by medical researchers, there are several risk factors that have been identified. These factors, which correlate with a higher chance of developing IBS, include:
● Having had an acute gastroenteritis infection. Around 10% of IBS cases arise after the person has recovered from a serious GI infection.
● Stress. Believe it or not, stress is a major factor in irritable bowel syndrome. When you’re psychologically stressed. it can affect the communication between the brain and the digestive system. Many people with IBS suffer from anxiety or depression, as well as other stress-related disorders like chronic fatigue syndrome.
What Kinds of IBS Medication are Available?
IBS can be incredibly uncomfortable and painful to live with. People with inflammatory bowel syndrome suffer from frequent or constant pain, diarrhea, constipation, and other difficult symptoms. Fortunately, there are several kinds of IBS medication available that can help keep the symptoms in check. Although there is no cure for inflammatory bowel syndrome, it can be managed with medication.
Different types of medication for IBS are useful for different subtypes of the disorder.
● Laxatives are used to treat IBS-related constipation. Most prescription laxatives either soften stool so that it can pass through, or encourage the muscle movement inside the intestines that moves digested food through them.
○ Polyethylene glycol is available over-the-counter under brand names including Dulcolax, or as a prescription drug. It’s usually used to relieve chronic long-term constipation.
○ Sorbinol is a type of sugar derived from alcohol. The human body metabolizes it very slowly, which is why it’s often used as a calorie-free sugar substitute. It also has a laxative effect, which results from its ability to draw extra water into the large intestine. The water helps to soften and push out the stool.
○ Lactulose, like sorbinol, is a non-digestible sugar. It acts as a stool softener, and works well for IBS and chronic idiopathic constipation.
○ Lubiprostone is another laxative used for IBS. It activates certain epithelial cells on the inside of the digestive tract, causing the release of fluid secretions that soften stool and promote bowel movements.
● Antispasmodics are drugs for IBS that reduce muscle spasms. For patients with IBS, they can be very helpful for abdominal cramps and diarrhea.
○ Neurotropic antispasmodics like Donnatal and atropine work via the nervous system. Atropine, as well as, other ingredients in Donnatal like scopolamine, are largely derived from plants of the nightshade family.
○ Musculotropic antispasmodics work directly on the smooth muscle of the digestive organs. These can relieve the muscle spasms that cause abdominal cramps, without affecting gut motility. Unlike neurotropics, musculotropic drugs for IBS do not have many side effects.
● Serotonin agonists increase the effects of serotonin. This neurochemical is mostly known for its mood-related effects, but it also plays an important role in the GI system.
○ Tegaserod is a selective serotonin agonist, binding to a specific type of serotonin receptor. This drug has proven effective as a drug for IBS to reduce constipation, although it’s more effective in women than in men. It also helps to relieve abdominal pain and bloating.
○ SSRIs are usually used as antidepressants, but they can also be prescribed as an IBS medication.
● Probiotics contain bacteria that naturally live in the digestive system. Some species of probiotics have been found to reduce abdominal pain in irritable bowel syndrome.
Other Ways to Manage IBS
Along with medication, there are also other effective approaches for managing the symptoms of irritable bowel disorder. IBS is a complex condition, and it’s becoming apparent that environmental and psychological factors play a major role. IBS symptoms often respond well to non-pharmaceutical treatment methods, including:
● Dietary changes. Studies have shown that as many as 70% of people with irritable bowel syndrome eat a diet that’s too high in “FODMAPs.” FODMAPs are certain types of carbohydrates, and for some people, they’re difficult to absorb. One of the biggest offenders is wheat. Some fruits are also high in FODMAPs, especially stone fruits like plums, apricots, peaches, nectarines, and cherries. Many also have some degree of lactose intolerance. It may be beneficial to avoid milk and milk products, in favor of products like soy milk, almond milk, and non dairy creamers. Increasing dietary fiber can also be a helpful change for managing IBS. This can include both fiber supplements, and high-fiber foods. These kinds of dietary considerations can often reduce constipation, diarrhea, bloating, and other symptoms of IBS.
● Psychological therapies can help with IBS, which correlates highly with stress, anxiety, and depression. Cognitive behavioral therapy, a form of psychotherapy that focuses on identifying and changing harmful patterns of thought and behavior, can help IBS patients to better cope with distressing symptoms, as well as the embarrassment that IBS can cause. In some cases, hypnotherapy has even proven helpful for increasing mental well-being.
● Stress relief beyond psychotherapy is also helpful for coping with IBS. Meditation, yoga, tai chi, and regular moderate exercise can all help reduce stress, which tends to exacerbate the symptoms of inflammatory bowel disorder.
Medicine for irritable bowel syndrome can’t cure the condition, but it can go a long way towards managing the persistent and uncomfortable symptoms. For IBS patients with chronic constipation, which causes pain and bloating, prescription laxatives can be incredibly helpful for restoring normal bowel movements. When IBS is dominated by chronic diarrhea, which interferes with daily life in addition to being uncomfortable, antispasmodic and anti-diarrhea medications can help. A diet higher in soluble fiber can also be beneficial for reducing diarrhea. There are also antispasmodic medications, which are sometimes used for severe cramping with diarrhea.
Different medications may work better or worse for different patients. When you talk to your doctor about your IBS diagnosis and treatment options, they may ask you to try a couple of different medications before you find something that works for you. IBS is complex and individually variable, and what works well for someone else might not work for you. Your doctor will work with you to find treatment options, including medication, that can help keep your symptoms in check. With the right medications, you can stop worrying about when your symptoms will strike. IBS can interfere significantly with your ability to live your day-to-day life, and finding ways to treat your condition is important for your health, happiness, and sense of well-being. If you suspect you may have IBS, talk to your doctor about your symptoms, and they can help you find relief.