Medications For Irritable Bowel Syndrome

Medications for irritable bowel syndrome may work well when combined with natural remedies for IBS. Mnay times patients will enter a doctor's office with the question: "Is there an irritable bowel syndrome cure?" Unfortunately a cure does not exist, but effective management does. It is important first of all to get and accurate diagnosis and distinguish IBS from other bowel diseases such as colitis.

Because of the seratonin receptors in the gut, there is a theory that this may be the connection to migraine.

One of the hallmarks of treating irritable bowel syndrome symptoms has been to recommend increasing fiber. But what kind? Did you know that there are two kinds?

Insoluble fiber should be avoided as it may acutally cause more problems for you. This is the fiber in raw vegatables, raw fruits and wheat bran. Insoluble fiber acts by binding bile, bulking stools and increasing water content of stool. This eases the passage of the stool. It also balances the stool and will help prevent diarhhea, which is the body's natural response to correct constipation.

Soluble fiber will help your symptoms. Try the over the counter soluble fibers that you can mix with water. This is particularly good if constipation is your predominant symptom.

Below is a chart for the basic management of IBS depending on whether you have mild, moderate or severe symptoms.

Adapted from Mertz HR. Irritable bowel syndrome. N Engl J Med 2003;349:2142.

Medications For Irritable Bowel Syndrome

Treatment	Initial Dose	Maintanence Dose	Comments
Loperamide (Immodium)	Follow over the counter dosing.	Do not exceed max OTC dosing.	Slows intestinal transit and water reabsorption. Slows diarrhea.
Dicyclomine (Bentyl)	20mg 4x/day.	20-40mg 4x/day	Anti-spasmotic. If not effective after 2 weeks, discontinue.
Hyocyamine (Levsin)	0.125-0.250mg every 4 hrs.	Same.	Anti-spasmotic. Maximum 1.5gms per day.
Amitriptyline	10-25 mg 2 hours before bed.	10-100mg 2 hours before bed.	Reduces pain and diarrhea. Start with a low dose and titrate up slowly.
Despiramine (Norpramin)	10-50mg at bedtime.	10-150mg at bedtime.	Reduces pain and diarrhea. Start with a low dose and titrate up slowly.
Alosteron (Lotronex)	1 mg per day x 4 weeks.	1mg once or twice a day.	For severe diarrhea prominent IBS in women. Used with caution, risk of ischmic colitis.

Herbs For Irritable Bowel Syndrome

In addition to medications for irritable bowel syndrome, many symptoms have often responded to complementary therapies and many doctors now recommend using them with prescribed medications.

Oil of peppermint is a very good anti-spasmotic and has been associated with improved bowel function. Research studies have shown that there are also mild anti-nausea properties in addition to anesthetic properties. Here is more information about this mint herb.

Ginger in the form of ginger tea is also quite good for the nausea and irritable bowel syndrome. Ginger also promotes bowel function gently by increasing motility.

Aloe vera is good for constipation dominant IBS, and fennel helps with the gas and bloating associated with IBS.

Probiotics are microbes that are deemed to restore an imbalance in the normal flora of the intestines. Some studies have shown and improvement in irritable bowel syndrome symptoms.

Clearly, a combination of medications and alternative therapies seems to be the best approach to IBS. Exercise is important too, as this promotes bowel function, especially if constipated.