Treatment for IBS With Diarrhea (IBS-D)
Over-the-Counter (OTC) Medicines
Your doctor may suggest trying OTC diarrhea medicines such as bismuth subsalicylate (Kaopectate, Pepto-Bismol) and loperamide (Imodium) for relief.
Researchers have found these drugs can help slow diarrhea, but they won’t help with other IBS symptoms like belly pain or swelling.
Side effects of these treatments include belly cramping and bloating, along with dry mouth, dizziness, and constipation.
If you take a diarrhea medicine, use the lowest dose possible and don't take it for a long time.
Some OTC medicines for gas relief, such as simethicone (Gas-X, Mylicon), are generally safe.
Some antacids, especially those with magnesium, can cause diarrhea.
Don't take any OTC medicine for the long term without asking your doctor about it. IBS symptoms can be caused by other, more serious problems. Make sure you and your doctor have ruled out other causes of your symptoms.
Your doctor can recommend different types of prescription drugs to help your IBS-D:
Antidepressants. If your doctor recommends one, it doesn't necessarily mean that you are depressed. These drugs can help with belly pain from IBS. Low doses of them can help block pain signals to the brain.
For people with IBS-D, doctors may recommend a low dose of a tricyclic antidepressant such as amitriptyline, imipramine (Tofranil), or nortriptyline (Aventyl, Pamelor). Common side effects of these meds include dry mouth, blurred vision, and constipation. Your doctor may recommend another type of antidepressant called an SSRI, which includes citalopram (Celexa), fluoxetine (Prozac), and paroxetine (Paxil), if you have depression along with IBS. Side effects of these medicines sometimes include diarrhea, so be sure to let your doctor know if your symptoms of IBS-D get worse while you’re taking any of these medicines.
Drugs that relax muscles, called antispasmodics, such as dicyclomine (Bentyl) and hyoscyamine (Levsin). Muscle spasms in your digestive tract can cause belly pain. Many doctors prescribe these drugs to calm them. But some studies have found there’s no clear evidence that they help everyone with IBS.
Side effects of these drugs include decreased sweating, constipation, dry mouth, and blurred vision.