Medications For Ibs - Irritable Bowel Syndrome: Digestive Disorders

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Medications for IBS

If you have symptoms that are troublesome enough to stop you from participating in normal activities, talk with your doctor about drug therapy. While medications can't cure the condition, they may ease the symptoms.

Anticholinergics. These medications, including atropine and related agents, dicyclomine (Bentyl), or hyoscyamine (Levsin), may relieve mild abdominal pain by reducing bowel spasms. People who often experience cramps after eating may obtain some relief if they take one of these medications before meals.

Antidepressants. Medications such as amitriptyline (Elavil, Endep) and desipramine (Norpramin) may be prescribed for patients who have pain-predominant IBS. These tricyclic antidepressants should be used at low doses and only by patients who have diarrhea-related IBS because they can cause constipation. The selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), may be helpful in treating abdominal pain in patients who have either diarrhea- or constipation-related IBS, but the SSRIs have not been studied extensively in IBS yet.

Other medications. Current research is focusing more on the gut-brain connection, which appears to play a role in IBS, with serotonin-like medications among those being investigated. However, the first of these to be approved, alosetron (Lotronex), which works on the serotonin type III receptor, was temporarily taken off the market in 2000 because of colitis and severe constipation that resulted in 44 hospitalizations and 5 deaths. Lotronex is now available for women by prescription but only under a tightly controlled prescribing program. Another drug in this class, tegaserod (Zelnorm) was voluntarily removed from the market in April 2007 when clinical trials showed a small but significant increase in risk of heart attack, stroke and severe heart chest pain among people taking tegaserod compared to people taking a placebo.

Loperamide (Imodium) and diphenoxylate (Lomotil) are generally recommended for patients whose main complaint is diarrhea. Loperamide, available over the counter, reduces the secretion of fluid by the intestine. Diphenoxylate, available by prescription only, helps to slow down intestinal contractions. It is related to codeine and contains atropine as well.

Last updated:	August 21, 2007