Conventional Treatment Details for Irritable Bowel Syndrome (IBS)
Conventional medicines for IBS are directed to relieve the symptoms associated with IBS. However, they fail to rectify deranged brain-gut communication and hence can merely provide symptomatic relief. However, they cannot cure the condition. Moreover, the majority of them have inherent side effects, and they may not be beneficial to every individual.
Conventional medications used in the treatment of IBS include (but are not limited to):
01 Anti-spasmodic drugs like Bentyl and Levsin are considered part of the class of anticholinergic drugs. Anti-cholinergic drugs act by decreasing the abnormal sensitivity of cholinergic (muscarinic M2) receptors in gut smooth muscle.
02 Antacids/anti-gas medications (e.g., Simethicone or BEANO). They aid in the reduction of embarrassing flatulence and the accompanying lower abdominal pain.
03 Anti-diarrhea medications/opioid-receptor agonist (e.g., loperamide or "Immodium"). It delays small and large bowel transit, decreases intestinal secretory activity, and increases rectal sphincteric muscle tone.
04 Prokinetic Agents (e.g., Cisapride or "Propulsid"): These drugs have been reported to help in gastroesophageal reflux disease and dyspepsia related to delayed gastric emptying. Its efficacy in constipation-predominant IBS, however, has not been well established.
05 Antidepressants. Tricyclic antidepressants (e.g., amitriptyline, imipramine, and desipramine) or serotonin reuptake inhibitors (e.g., fluoxetine, sertraline, and paroxetine) are commonly used to treat IBS. Although commonly used in IBS patients, their efficacy is still being debated. The therapeutic effect can take as long as 4-6 weeks.
06 Smooth muscle relaxants have direct relaxant properties on gut smooth muscle.
07 Laxative: Laxatives are used for patients with severe constipation. However, their use is limited as these are habit-forming drugs.
08 Fiber supplements: Large amounts of beneficial fiber can be obtained by taking over-the-counter bulking agents such as psyllium mucilloid (Metamucil, Konsyl) or methylcellulose (Citrucel).
09 Alosetron slows intestinal movement and may reduce nerve problems that could be contributing to IBS. Some people experience constipation after using alosetron.
Written & Approved by-
Dr. Rajesh Shah
M.D. (Hom.)