Welcome to the IBS medications section to help you understand the drugs you are given to help manage your symptoms.
The drugs don’t work for everyone, but I would estimate an overall benefit to to most sufferers.
Irritable Bowel drugs are used by most people as an adjunct treatment in combination with other options such as diet, lifestyle and natural remedies.
When you embark on any medication, you always have to consider the benefits against the side effects of the drug you take.
They can be used to help improve symptoms such as pain, diarrhea and constipation.
IBS medications are not a cure, but they are a way of allowing you to take control of your bowel movements and pain issues, something that I believe is very important to anyone with the condition.
The choice of drug depends on the type of IBS you suffer from.
They can be broadly divided into antispasmodics, laxatives, antidiarrheals, bulking agents and miscellaneous IBS drugs.
I would particularly advise using them when your symptoms are severe or when more conservative measures such as diet and lifestyle are ineffective.
Let's take a break a moment and try this quick survey......
Antispasmodic drugs are used for pain relief and are particularly good when you have cramps.
They have relatively widespread use as IBS medications and some of them may already be familiar to you.
They work by reducing the spasm symptoms that can be experienced in all forms of IBS.
The most common ones used are Mebeverine, hyoscine butylbromide (Buscopan) and Peppermint Oil Capsules (Mintec, Colpermin).
Mebeverine and hyoscine are so called anticholinergic drugs which have an effect on your gut muscles at a cell level, to help reduce bowel spasm and pain.
Like all drugs, these medications do have side effects in some people.
The most poorly tolerated of these are the so called antimuscarinic effects which include dry mouth, blurring of vision and urine retention which you can get with both mebeverine and hyoscine butylbromide.
Thankfully, these side effects are generally well tolerated, so they shouldn't be ignored on the grounds of possibly getting these symptoms.
Peppermint Oil capsules work on anti-pain channels to reduce the pain of IBS.
They are a natural product and come in capsule form to allow passage of the medication in to the bowel without it causing any irritation in your mouth.
They have very few side effects, which is great news for you, although they may increase reflux symptoms if you are susceptible, as they can relax the sphincter mechanism between your esophagus and stomach.
Antidiarrheals are used in diarrhoea predominant Irritable Bowel Syndrome.
These drugs work by reducing your gut contractility, but should be used with caution, as they can increase your spasm symptoms too.
The common ones used are Loperamide, Co-Phenotrope and Codeine Phosphate.
They are from the same family of drugs as the opiates morphine and diamorphine (heroin), but much weaker.
They work by stimulating opiate receptors in the bowel wall which in turn reduces your guts contraction and bowel movements.
Antidiarrheal IBS medications do have side effects and these include abdominal pain, nausea, drowsiness, dizziness and bloating in some people.
Some IBS-D sufferers don’t like antidiarrheal medication because of the constipating effect, which has always seemed a bit of a paradox to me!
The other group are the bulking agents which work by 'bulking up' your bowel motion, aiding the passage of stool through your gut.
Its action is achieved by the physical bulk as well as drawing fluid in to the fiber and stool.
The commonly used bulking agents are Ispaghula Husk (Fybogel), Sterculia or Normacol and Methylcellulose which can be used in all forms of IBS.
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Sterculia or Normacol
Peppermint Oil Capsules
Miscellaneous IBS medications include antidepressants, 5-HT3 antagonists (Alosetron) and 5-HT4 antagonists (Tegaserod).
I won’t go in to detail with these drugs as the latter two are rarely used now, but if you click on their links you can find out more detail including indications, doses and common side effects.
There are also newer drugs being developed for IBS-C, particularly in refractory or resistant symptoms. These include the drugs Linaclotide (Linzess and Constella), Amitiza (Lubiprostone) and Prucalopride (Rosolor).
So, in summary, Irritable Bowel Syndrome medication can help some sufferers, but should be thought of as an adjunct rather than a cure in the management of your IBS.