Irritable bowel is characterized by recurrent episodes of abdominal pain accompanied by diarrhea, constipation or alternating bouts of each. Those who have these symptoms at least three times a month for three months may have irritable bowel syndrome. Most treatments for irritable bowels are available without a prescription. For severe symptoms or symptoms that last longer than three months, it's advisable to see a doctor.
Diet Change
The National Institutes of Health advises eliminating high-fat foods, milk products, chocolate, caffeine, alcohol and carbonated beverages and increasing consumption of fiber-rich foods such as whole grains, fruits and vegetables as diet changes. Keeping a food diary that describes food intake, specific symptoms and times for both can help identify additional triggers.
Stress Management
In the 2008 edition of "Harrison's Principles of Internal Medicine," Dr. Chung Owyang, chief of gastroenterology at the University of Michigan Health System, reports that several lines of evidence link emotional disorders and stress to irritable bowels. Counseling, exercise, meditation, hypnosis and other stress management strategies often improve irritable bowel symptoms and enhance response to other treatments.
Antispasmodics
Anti-spasmodics such as dicyclomine, hyoscyamine and belladonna-phenobarbital can relieve cramping caused by intestinal spasms. Anti-spasmodics work best when patients take them 30 to 60 minutes before a meal, but often cause unacceptable side effects such as blurred vision, constipation, decreased sweating, dizziness, headache, nausea and urinary retention, which is why they are available by prescription only.
Anti-Diarrheals
Loperamide, a drug related to morphine, effectively combats diarrhea caused by irritable bowel by decreasing fecal transit time and blunting perception of stool in the rectum. Loperamide is available over-the-counter and does not cause narcotic addiction because it remains almost entirely in the bowel.
Antidepressants
Antidepressants modulate communication between nerves in the bowel, much as they do for nerves in the brain. Selective serotonin reuptake inhibitors work best for patients who mainly suffer from pain accompanied by depressed mood and constipation, according to the Mayo Clinic. Tricylic antidepressants work best for patients who mainly suffer from diarrhea and pain without depressed mood. All antidepressants require a prescription.
Digestive Enzymes
Over-the-counter lactase and beta-glycosidase supplements--such as Lactaid or Lactrase and Beano--correct deficiencies of these enzymes, improving symptoms related to the ingestion of dairy products, legumes and vegetables. Prescription pancreatic enzymes may alleviate symptoms related to the ingestion of large meals and high-fat foods, according to a 2010 report in the journal Clinical Gastroenterology and Hepatology.
Chloride Channel Activators
Prescription lubiprostone selectively activates chloride channels in the cells lining the intestine. Sodium and water follow passively, softening stool and lubricating its passage through the intestine. A 2010 report in Digestive Diseases and Sciences found that most constipated patients experienced relief within 24 hours, relief that was sustained throughout the entire course of treatment.
References
- Irritable Bowel Syndrome (Chapter); C. Owyang; In: "Harrison's Principles of Internal Medicine, 19th ed.;" A.S. Fauci, E. Braunwald, D.L. Kasper et al. (eds); 2008
- National Institutes of Health: What I Need to Know about Irritable Bowel Syndrome
- Mayo Clinic: Irritable Bowel Syndrome: Treatments and Drugs
