Your guide to medication for irritable bowel syndrome (IBS)

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

There’s no way to cure IBS permanently, but you can manage it effectively with medications and self-care strategies.

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

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Medications for IBS

The best medication for IBS will depend on the exact type you have. IBS can be categorized into three types:

• IBS with constipation (IBS-C)
• IBS with diarrhea (IBS-D)
• mixed IBS (IBS-M)

IBS-M has features of both IBS-C and IBS-D, causing constipation and diarrhea at different times. So the same medications used for IBS-C and IBS-D can also be used for the mixed form.

IBS-C

The key symptom of IBS-C is infrequent, hard-to-pass bowel movements, along with bloating and abdominal pain. Some medications can specifically manage this aspect of IBS.

Laxatives are often available OTC and can help make bowel movements easier. They’re primarily used for long-term (chronic) constipation but may also benefit individuals with IBS-C. Examples include polyethylene glycol (MiraLAX) and bisacodyl (Dulcolax). Lactulose (Kristalose) is another option that requires a prescription.

Some prescription medications for IBS-C include:

• lubiprostone (Amitiza)
• linaclotide (Linzess)
• plecanatide (Trulance)

These medications can help move waste through your digestive system. However, like any medication, they may have their side effects. For example, they may cause nausea, gas, vomiting, or severe diarrhea. If you experience side effects, consider speaking with a healthcare professional.

IBS-D

IBS-D has symptoms that are similar to those of other IBS types. But the key features of IBS-D are loose stools and the sudden urge for bowel movements. Around one in three people with IBS-D may experience loss of control of their bowels.

Some OTC medications may help with IBS-D, although they may not be approved specifically for this condition.

Some medications can help manage this diarrhea specifically, such as:

• loperamide (Imodium)
• dicyclomine (Bentyl)
• hyoscyamine (Levsin)
• alosetron (Lotronex)
• rifaximin (Xifaxan)

Other medications

Doctors may prescribe certain medications to manage symptoms that occur with all forms of IBS, like bloating, abdominal pain, and mental health effects.

• Antispasmodics: Antispasmodics can help reduce abdominal pain associated with IBS. Note that antispasmodics may cause constipation, so they may be better for managing IBS-D. Examples include mebeverine hydrochloride (Colofac), alverine citrate (Spasmonal), and butylscopolamine (Buscopan).
• Antidepressants: Certain antidepressant drugs, including tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), can help manage abdominal pain. They may also ease depression and anxiety in people with IBS. Examples include amitryptiline (Elavil) and fluoxetine (Prozac).

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Other treatments

You can take other steps to manage IBS in addition to medication. Doctors might recommend these measures before prescribing medications. These options include the following:

Diet and lifestyle

Doing regular exercise, avoiding stress, and getting quality sleep may help relieve IBS symptoms.

You may also consider adjusting your diet. In fact, dietary changes are often the preferred treatment method for IBS before medications. Specific changes that may help include:

• identifying foods that tend to trigger your symptoms
• 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 eliminating FODMAPs for a couple of weeks helps with your IBS, you may be able to gradually reintroduce some of these foods in small amounts.

Supplements

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

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

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

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.

According to a 2023 review, psychotherapy approaches can ease symptoms and improve the quality of life in people with IBS. The review suggested that CBT can help change how a person interacts with foods, which can improve their gut health and, in turn, ease their symptoms.

Summary

Medications, diet changes, supplements, and psychotherapy are all ways to manage IBS symptoms. The best medication will depend on what type of IBS you have. For example, some drugs are better for constipation, while others can help with diarrhea.

Alongside medications, lifestyle changes and supplements may help ease your symptoms. Changing your diet may be beneficial for your condition. Research suggests that psychotherapy approaches may also help.

Consider speaking with a healthcare professional if you think you have IBS. They can help create a treatment plan that works for you.

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