Irritable bowel syndrome 101 part 8

The treatment for each patient is individualized and based on type and severity of symptoms.

Constipation-predominant IBS with mild symptoms may benefit from

- Increased fluid intake
- Guar gum
- Exercise
- Fiber

For constipation-predominant IBS with moderate symptoms,

- An antispasmodic (Bentyl)
- Peppermint oil
- Osmotic laxative

In severe cases, the above therapies may be supplemented with

- Tricyclic antidepressants
- Psychotherapy
- Consideration of drug like Paxil/lotronex

For diarrhea-predominant IBS, begin with

- Dietary changes
- Use an antispasmodic (Bentyl)
- Alternatively, peppermint oil if symptoms are moderate.

In severe diarrhea-predominant IBS,

- Consider tricyclic antidepressants
- Add a serotonin 5-HT3 antagonist (lotronex if patient is female).

In pain-predominant IBS

- Use an antispasmodic (Bentyl)
- Tricyclic antidepressant

If severe with diarrhea

- Consider a serotonin 5-HT3 agonist (lotronex).