Medication for irritable bowel syndrome (IBS): 3 options

Irritable bowel syndrome (IBS) treatment focuses on relieving symptoms to help you feel better. Many people use over-the-counter (OTC) drugs, prescription medications, or both to relieve IBS symptoms. Eating certain foods and speaking with a mental health professional can also help.

Some medications may cause side effects or come with risks, so it’s important to speak with a doctor before taking any new medication.

Hyoscyamine 

Hyoscyamine slows movement in your intestines and stomach. It also reduces how much stomach acid and other fluids your body makes.

This medication is available with a prescription in a tablet or liquid to take three or four times a day. Some people prefer the extended-release version, which you take twice a day. 

If you take an antacid, hyoscyamine won’t work as well. You can look at the directions on the package or ask the pharmacist when to take hyoscyamine if you take other medications.

There are many brand names for hyoscyamine:

• Symax Duotab
• Anaspaz
• Levbid
• NuLev
• Ed-Spaz
• Levsin
• Oscimin
• Hyosyne

Note that hyoscyamine is not currently approved by the Food and Drug Administration (FDA). It’s advisable to talk with a doctor before taking this medication.

You may have some side effects while taking hyoscyamine, such as:

• drowsiness
• dizziness, headache, or lightheadedness
• feeling flush
• blurry vision
• light sensitivity

Some side effects may affect your digestive system, leading to:

• constipation
• dry mouth
• difficulty urinating

The more serious side effects include:

• diarrhea 
• skin rash
• eye pain
• an irregular or fast heart rate

If you need help covering the cost of medications, Optum Perks free Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Diphenoxylate atropine 

Diphenoxylate atropine is sold under the brand name Lomotil. This combination drug contains two medications:

• diphenoxylate to treat diarrhea
• atropine to cause side effects to prevent people from taking too much of the medication

You may take diphenoxylate atropine while taking other steps to treat diarrhea, like staying hydrated, eating bland foods, and replacing electrolytes.

You can take Lomotil four times per day as a pill or liquid, and most people feel better within 48 hours. If you don’t feel better within 10 days, you can stop taking the medication and talk with a doctor. 

Lomotil can become habit-forming, so it’s important to only take as much as your doctor prescribes. They may recommend taking less when your IBS symptoms get better.

Common side effects of Lomotil include:

• headache
• restlessness
• tiredness
• confusion
• mood changes

Some of the side effects may affect your digestive system, leading to:

• stomach discomfort
• nausea
• vomiting
• loss of appetite

There are also more serious possible side effects that require emergency medical attention. Call 911 or your doctor if you experience:

• hallucinations or hearing voices
• numbness in your legs or arms
• ongoing stomach pain
• stomach bloating
• shortness of breath
• problems breathing or swallowing
• hoarse voice
• hives, rash, or itching
• swelling 

Lomotil is a controlled substance. A doctor may only be able to fill a certain number of prescriptions for the drug. It’s important to follow the doctor’s advice on dosage and reach out if you experience serious side effects. 

Loperamide

Loperamide is sold under the brand name Imodium. You can get Imodium without a prescription. 

Imodium helps to treat diarrhea. You can take this medication right after you experience diarrhea.

It’s important not to take more Imodium than recommended. Unsafe amounts can cause serious heart problems. The FDA mandated changes to loperamide packaging in 2019 to encourage safe use.

Common side effects of loperamide include:

• constipation
• fatigue 

You should call your doctor or 911 if you have any of these more serious side effects of loperamide:

• dizziness or lightheadedness
• irregular, fast, or pounding heartbeat
• hives, itching, or rash
• peeling or blistering skin
• changes to skin color
• wheezing or difficulty breathing
• fever
• stomach swelling or pain
• blood in your poop

Speak with your doctor if you have a history of heart problems, like an irregular heartbeat, as they may recommend avoiding Imodium.

Other treatments

You can take other steps to treat IBS in addition to medication. These options include changes to your diet and seeking mental health support.

Diet and lifestyle

Regular exercise, avoiding stress, and quality sleep may help relieve IBS symptoms.

You can also change your diet. Specific changes that may help include:

• eating high fiber foods to soften stools
• avoiding gluten, even if you don’t have celiac disease
• following a low FODMAP diet

A low FODMAP diet avoids foods that have certain hard-to-digest carbohydrates. Here are some examples of FODMAPs:

• some fruits, including apples and pears 
• fruit juices 
• dried fruits
• canned fruits in fruit juice
• some vegetables, including asparagus, lentils, and mushrooms
• dairy products
• wheat and rye
• honey, high fructose corn syrup, and sweeteners ending in “-ol,” like sorbitol

If you find eliminating FODMAPs for a couple of weeks helps with your IBS, you may be able to reintroduce some of these foods in small amounts.

Supplements

You may find that some supplements help your stomach to feel better. They may also improve your IBS symptoms. Some examples are:

• coated peppermint oil capsules for stomach pain
• probiotics to promote healthy gut bacteria

Supplements may not be proven to help with IBS. They may also come with risks. Talk with your doctor about whether they may be right for you. 

Psychotherapy

People with IBS sometimes benefit from talk therapy or other mental health therapies like:

• cognitive behavior therapy (CBT)
• hypnotherapy
• relaxation training

These therapies can help you relax, reduce stress and anxiety, and change your thought patterns. In the process, your IBS symptoms may get better.

Summary

Medications, diet changes, supplements, and psychotherapy are all ways to manage IBS symptoms. Drugs come with certain risks. Your doctor can help you develop a plan to treat your IBS that is safe and works for you.