As with many other disorders, prevention is the key. By effectively managing stress
levels, exercising, drinking plenty of water, eating a high-fiber diet, and avoiding foods
that seem to aggravate symptoms (e.g. beans, cabbage, and caffeine), often the need for
daily medications is avoided.
For all with IBS, and especially those with a strong constipation component, a
high-fiber diet that includes ½ to 1 cup of bran daily is important. Fiber
supplementation with psyllium (e.g. Metamucil) ½ to 1 tablespoon one to three times daily
in a large glass of water or juice, or calcium polycarbophil (e.g. FiberCon) 2 tablets one
to four times daily followed by at least 8 ounces of water may be necessary and, if
effective, should be used on a regular basis. Some people may experience temporary
bloating after starting on fiber supplementation. This usually passes within two to three
Scheduling toilet visits at the same time everyday can be helpful. Certain
prescription-only osmotic laxatives (e.g. Duphalac or Sorbitol) help the constipation but
may also increase bloating. Stool softeners (e.g. Colace) 50-200 mg daily can maintain a
good stool consistency. Medicines that calm the bowels or speed the propulsion of foods
are helpful for some with severe symptoms.
Antidiarrheal agents (e.g. Imodium A-D) one or two 2mg caplets three to four times a
day are used in those who have a strong diarrhea component.
Antidepressants, which have multiple uses including effective headache and back pain
treatment, can be used when pain is a predominant complaint. Even with no treatment,
symptoms disappear in over 30% of those affected as they get older.
The most important component of treatment in IBS is establishing a therapeutic,
communicative and trusting physician-patient relationship. Periodically completing a
symptom diary to review with your doctor may help identify factors that can aid your
Psychological treatments, which have studies to support their use, include relaxation
training, cognitive behavioral therapy, hypnosis, and individual psychotherapy.
IBS is a chronic condition that has no cure. However, there is hope that IBS patients
may be symptom-free for long periods of time.