Irritable Bowel Syndrome (IBS) Health Center

Irritable Bowel Syndrome

Going Natural continued...

Antidepressants for pain: About 25 percent of IBS patients find that antidepressants (usually given at lower doses than those prescribed for mood disorders) relieve pain. The best type, says Dr. Talley, depends on your major symptom: If you suffer from diarrhea, you may do better with an older tricyclic (Elavil, Norpramin, Tofranil), but if you have constipation, a newer SSRI (Prozac, Lexapro, Zoloft) may be more effective.

Antidiarrheal drug: If the runs are severe, your doctor can prescribe alosetron (Lotronex), which blocks the action of the brain chemical serotonin on the intestine, reducing cramping, pain, and urgency. Because in rare cases the drug can cause a serious drop in blood flow to the intestine, it's prescribed under a closely monitored FDA program.

Constipation Rx: Lubiprostone (Amitiza) increases the flow of salty fluids into the intestine, resulting in easier bowel movements and less stomach pain for about 18 percent of IBS sufferers.

The takeaway: Many IBS treatments — whether dietary shifts, exercise, alternatives, or prescription drugs — work for only a fraction of patients. But trying different ones, and combinations, can significantly boost the odds you'll be helped.

Double Trouble
Enjoying a meal without a backlash of unpredictable cramps and bathroom needs isn't the only challenge for IBS sufferers. Up to 79 percent also cope with painful heartburn — stomach acids backwashing up the esophagus and into the throat. Experts increasingly suspect this twofer isn't just bad luck, but rather one big, interconnected GI disorder. To lessen the blow:

Try an Acid Blocker
Proton pump inhibitors (Nexium, Prilosec, Prevacid) turn off stomach acid, reducing heartburn. They also may relieve IBS symptoms: In one Greek study, 41 percent of IBS patients reported significant relief after three months of using an acid blocker.

Cap the Coffee and Cocktails
Both can irritate the lining of the GI tract, triggering heartburn and IBS symptoms. If cutting back on your morning brew (to one cup) and alcoholic drinks doesn't provide relief, eliminate them.

Eat on Time
For IBS, you need to watch what you eat; for acid reflux, when is also key. Schedule dinner for at least two hours before bed, to allow time for food to travel down through the esophagus to the stomach; that way, acids won't wash back up.

Originally published on May 13, 2009

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