Irritable bowel syndrome — or “IBS” — is a very common disorder and one of the conditions that I see most often in my practice. In fact, researchers believe that about 55 million Americans suffer from IBS. However, just because IBS is common doesn’t mean that it’s easy to treat.
IBS is actually a very individualized illness, so symptoms can vary widely among patients. For example, some patients with IBS deal with chronic constipation, while others tend towards diarrhea. Similarly, treatments that work well for one patient might have no effect (or even make symptoms worse) for someone else. That’s why important to work with a healthcare professional, rather than trying to manage IBS symptoms on your own.
I prefer to use a patient-centered approach when treating IBS, which means that I work with each patient to formulate a unique treatment plan that addresses your individual symptoms and needs. However, there are several broad categories of treatments that we can choose from:
Diet and Lifestyle Changes
Dietary changes are often the first-line treatment strategy for IBS symptoms. This may include keeping a food diary to identify any problematic foods that exacerbate symptoms, meeting with a professional dietician, or restricting certain foods like gluten or dairy. Additionally, there are diets that have been developed specifically for people with IBS, such as the low FODMAP diet. Other lifestyle modifications, such as increasing exercise and practicing stress management techniques, can also be helpful.
Rifaximin
While researchers still don’t know what causes IBS, one theory is that the disorder is related to an overgrowth of bacteria in the intestines. An antibiotic called rifaximin has been used to treat IBS, with patients often reporting a reduction in bloating and other symptoms following treatment. Rifaximin may work by inhibiting the growth of gut bacteria, particularly in patients with diarrhea-predominant IBS.
Other Medications
Other medications may also be prescribed for IBS, such as antidepressants, antispasmodics, and antidiarrheals. Medications that treat constipation-predominant IBS include lubiprostone, linaclotide, and various laxatives. Remember that everyone is different, so these medications may not be right for every patient.
Probiotics and Other Supplements
The GI tract normally contains trillions of “good bacteria”, which aid in digestion and provide many other health benefits. Experts are still doing research in this area, but one theory is that IBS symptoms occur or worsen when the balance of “good bacteria” and “bad bacteria” in the gut becomes unbalanced. Taking probiotics might be one way to restore balance in the gut and reduce symptoms. There are many different types of probiotics, so you should work with your healthcare provider to choose the right one. Probiotics may not be recommended for all patients with IBS.
Other supplements may sometimes be used to complement these treatment strategies. These include digestive enzymes, fiber, and peppermint oil. As always, be sure to talk to your doctor before taking any supplements or other over-the-counter treatments.
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