Treating irritable bowel syndrome (IBS) isn’t a one-size-fits-all solution. The best treatment option for you depends on your symptoms, overall health, and what works best for your lifestyle.

For people with mild or occasional IBS symptoms, lifestyle changes are sometimes effective in treating IBS. Since IBS can cause a wide variety of symptoms, different classes of drugs are used to treat it. Guidelines for irritable bowel syndrome therapy are based on the severity of the disease, the type of IBS, tolerance of side effects, the age of the person with IBS, and any other health conditions they have or medications they use.

Continue reading to learn about treatment options for IBS.

1. Diet Changes To Avoid Triggers

Although IBS isn’t caused by the food you eat, your symptoms may be worse when you eat certain foods. Making diet changes may help reduce IBS symptoms. There isn’t one set of dietary recommendations that will provide the best results for every person with IBS.

Your healthcare provider or dietitian may recommend some of the following diet changes to avoid foods that could trigger IBS symptoms:

• Increase fiber — Including fruits, vegetables, and whole grains
• Avoid gluten — Including foods made from wheat, barley, and rye
• Limit lactose — Including foods made from cheese and milk
• Limit gassy foods — Including beans, cabbage, carbonated drinks, and chewing gum

One of the best ways to pinpoint which foods are well tolerated and which produce the worst symptoms is to keep a food diary. Over several weeks, take note of what you eat and how you feel throughout the day. It will likely become apparent which foods are problematic and which are safe.

2. Low FODMAP Diet

The low FODMAP diet has become a popular treatment for people with IBS. FODMAP is short for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” These are types of carbohydrates that are difficult to digest and can cause gas, bloating, and cramping.

Examples of foods with FODMAP carbohydrates include:

• Some fruits, such as apples, pears, plums, and mangoes
• Some vegetables, including artichokes, onions, broccoli, sprouts, and beets
• Dairy products
• Wheat products
• High-fructose corn syrup
• Honey
• Artificial sweeteners, such as xylitol and mannitol

The low FODMAP diet involves limiting these foods for a few weeks to see how you react. It’s important to talk to your doctor before you make changes to your diet. They can help you make sure you’re getting enough nutrients.

If your symptoms improve after trying a low FODMAP diet, your healthcare provider will help you slowly add some of the high FODMAP foods back into your routine.

3. Fiber Supplements

Adding more fiber to your diet can ease IBS symptoms, especially for people with IBS with constipation (IBS-C). If you can’t get enough fiber in your diet, a fiber supplement can help. Studies show that soluble fiber supplements, such as psyllium or methylcellulose, can be effective for preventing and treating constipation related to IBS.

In some cases, adding a fiber supplement can worsen constipation. To avoid this, increase your dose of fiber supplements slowly, and make sure to drink plenty of water.

4. Over-the-Counter Medications

Some people with IBS can find relief using over-the-counter medications.

Laxatives

Laxatives are medications that can help increase how often you have a bowel movement. Your healthcare provider may recommend an over-the-counter medication if you have IBS-C. Fiber supplements are considered a bulk-forming laxative.

Polyethylene glycol is an over-the-counter laxative recommended for IBS-C. Polyethylene glycol is an osmotic laxative that works by pulling more water into your colon to soften the stool. Magnesium hydroxide solution and glycerin are other osmotic laxatives.

Over-the-counter laxatives also include stool softeners, such as docusate, and stimulant laxatives, like senna and bisacodyl.

Antidiarrheal Medications

Antidiarrheal medications may help some people with IBS with diarrhea (IBS-D). Loperamide may help some people control diarrhea symptoms. However, loperamide doesn’t help most people with other IBS symptoms, such as abdominal pain or bloating.

5. Antispasmodics

Some doctors may recommend trying antispasmodics, medications that can help treat abdominal pain associated with IBS. They work by relaxing the smooth muscle that lines the intestinal walls. Examples of antispasmodics for IBS include dicyclomine (Bentyl) and hyoscyamine.

Gastroenterologists do not always recommend using antispasmodics for IBS. Although antispasmodics are commonly prescribed to treat IBS, there isn’t much evidence supporting their overall effectiveness. The studies that exist are older and small in size.

Additionally antispasmodic side effects are common, especially in older adults. These include:

• Constipation
• Dry mouth
• Blurry vision and dry eyes
• Dizziness
• Urinary retention (difficulty emptying your bladder)

6. Antidepressants

Some antidepressants can help reduce symptoms of IBS, like abdominal pain.

Tricyclic Antidepressants

Tricyclic antidepressants (TCAs) are an older type of antidepressant often used to help manage chronic pain conditions. It’s thought they work by affecting neurotransmitters like norepinephrine and dopamine, which play a role in how the brain and gut process pain. TCAs may also help slow down gut transit to improve abdominal cramping and diarrhea. For many people, TCAs are effective at a low dose that’s typically much less than that used to treat depression.

Examples of TCAs include:

• Amitriptyline
• Desipramine
• Imipramine
• Nortriptyline

Selective Serotonin Reuptake Inhibitors

Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that can help improve IBS symptoms, especially for people with constipation and depression. Unlike TCAs, SSRIs typically speed up gut transit, which may be more helpful in people with IBS-C.

SSRIs studied for IBS include:

• Citalopram
• Fluoxetine
• Paroxetine

7. Prescriptions Medications Specifically for IBS

Several medications have been approved by the U.S. Food and Drug Administration (FDA) to treat different types of IBS.

Constipation

If other treatments don’t improve constipation symptoms, your healthcare provider may recommend an IBS prescription medication for people with IBS-C. These include:

• Linaclotide (Linzess)
• Lubiprostone (Amitiza)
• Plecanatide (Trulance)
• Tenapanor (Ibsrela)

These medications work a little differently to help pass stools more easily. Lubiprostone works by drawing more fluid into the intestines. Linaclotide and plecanatide activate receptors in the intestines that increase the speed of food and waste passing through the intestines. Tenapanor also helps increase the movement of food and waste by affecting how the intestines handle sodium (salt).

Since these medications can cause diarrhea, there is a risk of life-threatening dehydration. Talk to your healthcare provider about the potential risks and benefits of prescription IBS-C treatments.

Diarrhea

Some FDA-approved treatments for IBS-D may help people who don’t improve with other treatments.

Rifaxamin (Xifaxan) is an antibiotic that helps decrease bacterial overgrowth in the intestines that can cause diarrhea. Rifaximin is a short-term treatment and is usually taken for 14 days at a time. The main side effect of antibiotics is an imbalance of the beneficial bacteria normally found in the digestive tract.

Eluxadoline (Viberzi) helps slow down bowel activity and improve diarrhea symptoms. It’s believed to work by making the nerves in the intestines less sensitive and slowing the movement of food through the gut.

For severe diarrhea in women with IBS, alosetron (Lotronex) may be prescribed when other treatments have failed. Alosetron is an antidiarrheal medication believed to work by reducing gastrointestinal secretions, slowing the transit of food through the intestines, and inhibiting nerves from signaling pain and discomfort. Alosetron is only recommended for women with severe diarrhea because it’s linked to rare but serious side effects. It’s been linked to severe constipation and ischemic colitis, a condition resulting from inadequate blood supply to the large intestine.

8. Alternative Treatments

Some people with IBS try approaches beyond traditional medicines.

Exercise

Regular exercise may help ease IBS symptoms by reducing overall inflammation, supporting digestion, and improving mental health. Regular exercise does not necessarily mean going to the gym or playing sports. Nearly any physical activity that increases your heart rate and makes you breathe more deeply can be beneficial.

Peppermint Oil

Peppermint oil has been shown to improve IBS symptoms and abdominal pain. It’s thought to work by relaxing intestinal muscles and reducing abdominal pain. Most people tolerate peppermint oil supplements well. However, it can cause heartburn in some people.

Gut-Directed Psychotherapy

Gut-directed psychotherapy targets the connection between the brain and the gut. Cognitive behavioral therapy and gut-directed hypnotherapy may help improve IBS symptoms when combined with other treatments.

Probiotics

Probiotics are beneficial bacteria normally found in your gut. Probiotics are sold as supplements in the form of pills, capsules, and powders. Many fermented foods naturally contain live probiotic cultures, including yogurt, sauerkraut, miso, soft cheeses, sourdough bread, and tempeh. Researchers haven’t determined what is the best strain of probiotic bacteria for people with IBS, but research is ongoing.

How Do You Manage IBS Daily?

Managing IBS on a daily basis involves a combination of healthy lifestyle habits, stress management, and IBS drug treatments when needed. Identifying and avoiding food and activity triggers can help you decrease your symptoms over time. Finding the right treatment for you may involve some trial and error.

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