Medical Treatment Options for IBS-D

Irritable bowel syndrome can be tough to live with. How tough? A 2015 survey from the American Gastroenterological Association found that 47% of people with IBS would give up their cell phone just to feel 1 month of relief from their symptoms.

In about a third of cases of this digestive disorder, people also get diarrhea. That's known as IBS-D.

Let your doctor know about your symptoms -- even if talking about them feels uncomfortable -- because there are more treatment options than ever.

Medications Specifically for IBS-D

Alosetron (Lotronex). For a long time, this was the only prescription medication approved to treat the condition. It can help relieve stomach pain and slow your bowels to relieve diarrhea.

But there can be serious side effects, so it’s only to be used by women with severe IBS-D whose symptoms aren’t helped by other treatments.

A similar drug called ramosetron is being studied. It may have fewer side effects, but more research is needed.

Eluxadoline (Viberzi). This signals your nervous system to help stop bowel spasms. It can also ease belly cramps and diarrhea.

Rifaximin (Xifaxan). Though it’s not clear what causes IBS-D, some experts believe the culprit may be too much bacteria in the small intestine. Rimaxifin is an antibiotic that was approved by the FDA in 2015 to treat IBS-D. It’s been shown to reduce both stomach pain and diarrhea.

Other Medical Options

Antidiarrheal drugs. In some cases, over-the-counter medicines like loperamide (Imodium) can improve diarrhea symptoms for people with irritable bowel syndrome.

Probiotics. Your gut has trillions of bacteria -- some helpful and some harmful. Some people may find that these so-called “good” bacteria offer relief from IBS-D symptoms like bloating and cramping. But more research is needed to find out which probiotic strains are best, and at what doses.

Bile-acid binders. These drugs help make your bowel movements more solid and less frequent.

Antidepressants: Medicines called tricyclic antidepressants can help reduce belly pain, particularly if you also have depression or anxiety. If you don’t have depression, your doctor may still prescribe these, but in smaller doses.


Antispasmodics. These drugs have long been used to help treat the symptoms of IBS-D by slowing down your bowels to make bathroom visits less frequent and less painful.

Mast cell stabilizers. About a quarter of people with IBS-D also have gastroenteritis, which makes your gut become inflamed. Some experts believe that could be a trigger for IBS. Mast cells control the release of histamine, which causes inflammation. These drugs help lower the amount of histamine your body makes.

K-opioid antagonists. Scientists are doing clinical trials of a promising drug called asimadoline, which may help reduce stomach pain and diarrhea without causing constipation.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on February 15, 2020



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