Irritable bowel syndrome 101 part 5

Antispasmodic agents

There are many patients with IBS who get frequent abdominal cramps. These individuals may benefit from anti spasmodic agents. These drugs can help relax the intestine and reduce intensity of contractions. Some of the common anti spasmodic used to treat IBS include dicyclomine (Bentyl) and hyoscyamine (levsin). A number of studies have shown that these agents are significantly better than sugar pills at reducing abdominal distension and cramps but do not alter constipation. To date, these agents have only been evaluated for short-term efficacy and long-term results remain unknown.

Antidiarrheal agents

Both Imodium and pepto bismol can decrease diarrhea and do work well in individuals with diarrhea type IBS. However, both these drugs have side effects and can immediately turn the diarrheal IBS type into the constipation variety. Use of these drugs should be used with caution and one should start at very low doses.

Antidepressant and antianxiety medications

Of all the medications for IBS, anti depressants have had great success. Many anti depressants have been shown to relieve pain with very low doses. How anti depressants relieve pain is not well understood but is believed to be to due to an action in the brain. These drugs also help reduce diarrhea and improve mental status. Many studies have been conducted on antidepressants and their role in IBS. Overall about 30% of patients show improvement. Among patients who do respond, many stop using the drug because of side effects.

Among the anti depressant shown to be beneficial include amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), and trimipramine (Surmontil).

Paxil has also been demonstrated to work well in some patients with IBS. However, experience with these drugs is limited and is not recommended as first line therapy. Other drugs that have shown to be beneficial in some patients with IBS include the benzodiazepines. However, these drugs are expensive, have side effects including dependence, and can interact with alcohol. Currently these drugs are only recommended for short-term use in acute situations