Medications For Irritable Bowel Syndrome

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Medication therapy in irritable bowel syndrome (Ibs), is regularly directed toward symptom control.

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Abdominal pain:

If abdominal pain is very severe, anti cholinergic group of medications (mebeverine hydrochloride) may be helpful. It relieves pain by moderating the plane muscle contraction of intestine.

Bloating:

Peppermint oil (Colpermin, Mintec) when taken before meal is found to be helpful to minimise bloating and abdominal pain. Also it is better to cut out items like carbonated drinks, vegetables like cauliflower, broccoli and cabbage.

Diarrhea:

Over- the-counter making ready like loperamide (imodium) is found to be beneficial to control diarrhoea.

Constipation:

Taking bulk forming fibre supplements such as isphaghula, psyllium (metamucil) or methylcellulose (Citrucel) may help to control constipation.
If constipation is still troublesome, laxatives like senna and lactulose would be helpful.

Other Medications:

Antidepressants:

If the symptoms are not controlled by above straightforward medications, doctors could try antidepressants to control the symptoms. There are two kinds of anti depressants that are found to be helpful in these cases.

Tricyclic anti depressants: (imipramine, amitryptaline)

Apart from reliving depression, these medications inhibit the action of neurons that control the intestine. These are particularly beneficial to control diarrhoea and abdominal pain in irritable bowel syndrome. The main side effects of these medications are dryness of mouth, drowsiness and constipation.

Selective serotonin reuptake inhibitor: (Ssri)

If tricyclic antidepressants are not helpful then the physician might try this class of antidepressant (fluoxetine, paroxetine). These medications act by controlling a selective chemical in the nerve cells (neurons). They are found to be beneficial in controlling the symptoms of Ibs, particularly the abdominal pain and constipation.
If antidepressants are not working, physician may advise counselling, particularly in patients in whom stress provokes the symptoms of Ibs. In some patients hypnotherapy may be helpful.

Lubiprostone: (Amitiza)

This medication works by addition the fluid secretion in the small intestine. This is particularly beneficial in those patients who have Ibs with constipation. It is found to be beneficial in women, but its effectiveness in males is not yet convincing.

Alosetron: (loronex)

This medication can be prescribed only by doctors enrolled in a special programme as it is not licensed. This medication relaxes the colon and slows the movement of large bowel. It is found to be beneficial only in women who suffer from Ibs with intractable diarrhea.

Prognosis:

People suffer from irritable bowel syndrome has excellent prognosis. One study confirmed that 85% of patients were rendered virtually symptom-free in the short term. 68% were still virtually symptom-free 5 years later.

This article is the final part of "Walking with a Doc Series - Irritable bowel syndrome."

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