Medications such as dicyclomine (Bentyl) can help relieve painful bowel spasms. Your doctor might also prescribe a bile acid binder, such as cholestyramine (Prevalite), colestipol (Colestid) or colesevelam (Welchol). Over-the-counter medications, such as loperamide (Imodium A-D), can help control diarrhea.
If fiber doesn't help constipation, your doctor may recommend over-the-counter laxatives, such as magnesium hydroxide oral (Phillips' Milk of Magnesia) or polyethylene glycol (Miralax). Taking a supplement such as psyllium (Metamucil) with fluids may help control constipation. In addition, based on your symptoms your doctor might suggest medications such as: If your problems are moderate or severe, your doctor might suggest counseling - especially if you have depression or if stress tends to worsen your symptoms. FODMAPs are found in certain grains, vegetables, fruits and dairy products.Ī dietitian can help you with these diet changes. Some people are sensitive to certain carbohydrates such as fructose, fructans, lactose and others, known as FODMAPs - fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Research shows that some people with IBS report improvement in diarrhea symptoms if they stop eating gluten (wheat, barley and rye) even if they don't have celiac disease. If you experience bloating or gas, you might avoid items such as carbonated and alcoholic beverages and certain foods that may lead to increased gas. Your doctor might suggest that you eliminate from your diet: Mild signs and symptoms can often be controlled by managing stress and by making changes in your diet and lifestyle. Treatment of IBS focuses on relieving symptoms so that you can live as normally as possible. Irritable bowel syndrome care at Mayo Clinic.Your stool might be examined for bacteria or parasites, or a digestive liquid produced in your liver (bile acid), if you have chronic diarrhea. Bacterial overgrowth is more common among people who have had bowel surgery or who have diabetes or some other disease that slows down digestion. A breath test also can determine if you have bacterial overgrowth in your small intestine. Your doctor may order a breath test or ask you to remove milk and milk products from your diet for several weeks. If you don't produce lactase, you may have problems similar to those caused by IBS, including abdominal pain, gas and diarrhea. Lactase is an enzyme you need to digest the sugar found in dairy products. Your doctor might recommend endoscopy if celiac disease is suspected. A camera on the end of the tube allows the doctor to inspect your upper digestive tract and obtain a tissue sample (biopsy) from your small intestine and fluid to look for overgrowth of bacteria. A long, flexible tube is inserted down your throat and into the tube connecting your mouth and stomach (esophagus). This barium test is sometimes called a lower GI series. Your doctor might fill your large intestine with a liquid (barium) to make any problems more visible on X-ray. These tests produce images of your abdomen and pelvis that might allow your doctor to rule out other causes of your symptoms, especially if you have abdominal pain. Your doctor uses a small, flexible tube to examine the entire length of the colon. You may also have a number of other tests to rule out other causes for your symptoms. Your doctor may recommend several tests, including stool studies to check for infection or problems with your intestine's ability to take in the nutrients from food (malabsorption). If you have these signs or symptoms, or if an initial treatment for IBS doesn't work, you'll likely need additional tests. Diarrhea that is persistent or awakens you from sleep.Abdominal pain, especially if it's not related to a bowel movement, or occurs at night.Onset of signs and symptoms after age 50.Your doctor will also likely assess whether you have other signs or symptoms that might suggest another, more serious, condition.
For the purpose of treatment, IBS can be divided into three types, based on your symptoms: constipation-predominant, diarrhea-predominant or mixed. These criteria include abdominal pain and discomfort lasting on average at least one day a week in the last three months, associated with at least two of these factors: Pain and discomfort are related to defecation, the frequency of defecation is altered, or stool consistency is altered.
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