IBS treatment

There is no cure for IBS and only few treatment options are available today. Relief of symptoms is the most that can be achieved. The therapy includes drug treatment of the predominant symptoms and dietary restrictions. Unfortunately, in clinical trials both drugs and dietary interventions have been shown to help only subsets of IBS patients.

Drugs

The few available medical treatments for IBS target patient’s most troublesome symptoms. Antidepressants are used to relieve the abdominal pain, antidiarrhoeals for diarrhea, and laxatives for constipation. Unfortunately,even though some patients clearly benefit from the drugs, the IBS-specific drugs are not uniformly effective and overall produce disappointingly small differences from placebo (Chey 2016).

Rifaximin is an non-absorbable antibiotic inhibiting gut microorganisms.

Lubiprostone and Linaclotide produce laxation effect by increasing fluid secretion in the gut and thereby accelerating faecal transit. Diarrhoea is their common side effect, however

loperamide and Eluxadoline are medications for general diarrhoea. They works by slowing down bowel contractions, which allows the intestines more time to absorb fluid. As result, stool frequency and defaecation urgency are reduced. Through another unrelated mechanism the passage of stool through the gut is slowed down by Alosetron, Ramosetron and Ondansetron. A side-effect of those drugs is that their users become constipated.

Dietary alteration

The majority of IBS sufferers report that eating a meal triggers or aggravates their gastrointestinal symptoms (Bohn et al. 2013). Conversely, their symptoms tend to improve while they do not eat. Multiple studies have demonstrated the causative link between food and IBS symptoms (Shah et al. 2016). Thus, the diet seems an obvious starting point for treating IBS. Indeed, simply by choosing the right foods, many IBS patients managed to improve their symptoms and reduce their frequency. However, a universal diet relieving all the IBS patients does not exist and every patient must figure out his own right diet.