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Medications for Irritable Bowel Syndrome

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Since there is no known cause of IBS, medications are used to treat specific symptoms. There are several types of medications that are thought by some doctors to be helpful. But, not all of the medications listed below are of proven value in treating symptoms of IBS. In some cases, your doctor may recommend that you take a combination of medications.

Prescription Medications

Antispasmodics

  • Hyoscyamine
  • Cimetropium
  • Dicyclomine

Antidiarrheals

  • Loperamide

Antidepressants

  • Amitriptyline
  • Paroxetine

Prokinetic Agents

  • Domperidone
  • Cisapride
  • Metoclopramide

5-hydroxytryptamine (5-HT) Antagonists and Agonists

  • Alosetron

Anti-anxiety Medications

  • Diazepam
  • Alprazolam
  • Lorazepam

Antibiotics

  • Rifaximin

Miscellaneous Medications

  • Lubiprostone

Prescription Medications

Antispasmodics

Common names include:

  • Hyoscyamine
  • Cimetropium
  • Dicyclomine

These medications may quiet the digestive system and reduce painful bowel spasms. When taken in reasonable doses, side effects are generally mild.

Possible side effects include:

  • Dry mouth
  • Nausea
  • Lightheadedness
  • Vomiting
  • Changes in heart rate
  • Urinary retention
  • Visual problems
  • Sexual problems
  • Sleepiness
  • Confusion
  • Itching
  • Rash
Antidiarrheals

Common names include: loperamide (such as Imodium A-D)

These medications are relatives of morphine but much less addicting.

Possible side effects include:

  • Dry mouth
  • Nausea and vomiting
  • Allergic reactions
  • Sleepiness
  • Confusion
  • Lightheadedness
  • Euphoria
  • Drowsiness
Antidepressants

Common names include:

  • Amitriptyline
  • Paroxetine

Depression is a common symptom in people with IBS. Some of these drugs may have antispasmodic effects.

Possible side effects include:

  • Dry mouth
  • Nausea
  • Lightheadedness
  • Sleep disruption
  • Diarrhea
  • Drowsiness
  • Anxiety
  • Weight loss or weight gain
  • Impaired sexual function
Prokinetic Agents

Common names include:

  • Domperidone
  • Cisapride
  • Metoclopramide

Cisapride, a drug used to increase bowel motility, has been removed from the US market. But, it may still be prescribed in special cases.

Possible side effects of domperidone and metoclopramide include:

  • Headache
  • Dry mouth
  • Stomach ache
  • Diarrhea
  • Restlessness
  • Sleep disruption
5-hydroxytryptamine (5-HT) Antagonists and Agonist

Common name includes: alosetron

Alosetron may be prescribed to treat diarrhea, as well as general IBS symptoms, such as abdominal pain.

Possible side effects include:

  • Severe constipation
  • Nausea and vomiting
  • Stomach pain
Anti-Anxiety Medications

Common names include:

  • Diazepam
  • Alprazolam
  • Lorazepam

These medications may be prescribed to reduce anxiety associated with IBS.

Possible side effects include:

  • Drowsiness
  • Confusion
  • Impaired memory
  • Heart rate changes
  • Sleepiness
  • Constipation
  • Diarrhea
  • Rashes
  • Dry mouth
Antibiotics

Common names include: rifaximin

In some cases, antibiotics are recommended to treat IBS symptoms, such as bloating and diarrhea.

  • Lubiprostone

Lubiprostone may be useful in managing IBS when constipation is the primary symptom and fiber is unsuccessful.

Possible side effects include:

  • Nausea and vomiting
  • Headache
  • Stomach ache
  • Heartburn
  • Diarrhea
  • Linaclotide

Linaclotide may be used to increase the amount of fluid in the intestines.

Possible side effects include:

  • Diarrhea
  • Gas
  • Stomach ache

Over-the-Counter Medications

Fiber Supplements

Common names include:

  • Psyllium
  • Bran
  • Polycarbophil
  • Methylcellulose

Dietary fiber is the undigestible part of plants considered important in the optimal functioning of the digestive tract. Initially, fiber supplements may cause bloating and gas, which usually subside within a few weeks. Increase your fiber intake gradually. Drink plenty of water as you increase your fiber to promote regularity. Bran may be less effective than psyllium or other “soluble” fibers.

Possible side effects include:

  • Bloating
  • Flatulence
Antidiarrheals

Common names include:

  • Loperamide
  • Lomotil
  • Bismuth subsalicylate

Loperamide can cause constipation. Bismuth subsalicylate soothes the digestive tract without producing constipation.

Antiflatulents

Common name includes: simethicone

This drug breaks up bubbles in the stomach to make it easier for gas to exit upward, before it gets into the intestines.

Probiotics

Probiotics are "friendly" bacteria such as acidophilus, which is found in yogurt. Probiotics may help improve abdominal pain and other symptoms of IBS. These bacteria can also be bought as a supplement. Talk to your doctor if you are interested in adding probiotics to your diet.

Pain Relievers

Common names include: acetaminophen

Acetaminophen may relieve abdominal pain.

When to Contact Your Doctor

  • If the medication is not working
  • If you are getting worse
  • If you are having new symptoms

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Medications can be dangerous when mixed. Talk to your doctor if you are taking more than one medication, including over-the-counter products and supplements.

Revision Information

  • Reviewer: Daus Mahnke, MD
  • Review Date: 12/2015 -
  • Update Date: 12/20/2014 -
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  • Irritable bowel syndrome (IBS). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113627/Irritable-bowel-syndrome-IBS. Updated March 14, 2016. Accessed October 4, 2016.

  • Irritable bowel syndrome (IBS). Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal-disorders/irritable-bowel-syndrome--(ibs)/irritable-bowel-syndrome--(ibs). Updated July 2013. Accessed December 18, 2015.

  • Moeser A, Nighot PK, Engelke KJ, Ueno R, Blikslager AT. Recovery of mucosal barrier function in ischemic porcine ileum and colon is stimulated by a novel agonist of the ClC-2 chloride channel, lubiprostone. Am J Physiol Gastrointest Liver Physiol. 2007;292(2):G647-G656.

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  • 9/26/2006 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113627/Irritable-bowel-syndrome-IBS: Mueller-Lissner S, Tytgat GN, Paulo LG, Quigley EM, Bubeck J, et al. Placebo- and paracetamol-controlled study on the efficacy and tolerability of hyoscine butylbromide in the treatment of patients with recurrent crampy abdominal pain. Aliment Pharmacol Ther. 2006;23(12):1741-1748.

  • 9/18/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Bijkerk CJ, de Wit NJ, Muris JW, et al. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ. 2009;339:b3154.

  • 11/4/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Ford AC, Brandt LJ, Young C, et al. Efficacy of 5-HT3 antagonists and 5-HT4 agonists in irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol. 2009;104(7):1831-1843.

  • 1/11/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Wittmann T, Paradowski L, Ducrotté P, Bueno L, Andro Delestrain MC. Clinical trial: efficacy of alverine citrate/simethicone combination on abdominal pain/discomfort in irritable bowel syndrome: results of a randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2010;31(6):615-624.

  • 4/30/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Moayyedi P, Ford AC, Talley NJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010;59(3):325-332.

  • 2/18/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

  • 12/24/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Ford AC, Moayyedi P, Lacy BE. American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. Am J Gastroenterol. 2014;109 Suppl 1:S2-26.