Does IBS Have A Cure?

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IBS is typically considered a lifelong condition with exacerbations and remissions.1 Some people will recover completely.2 Management of symptoms will improve the outcome. Establishing realistic expectations for managing IBS is important in understanding the goal of treatment. The goal of treatment is to improve symptoms and quality of life, not to “cure” IBS. This may include reducing or discontinuation of medication.1

Treating IBS can be challenging because symptoms may return or be resistant to therapy.3 Treatment options, including drug therapy, are selected based on the dominant symptom and symptom severity.3,4 Below is a description of some of the treatment strategies and options that may be used to improve symptoms.

Choosing the right doctor

Being comfortable talking with your doctor about your IBS is an important part of managing symptoms. A positive interaction with your doctor is associated with fewer follow-up visits for IBS.3

Exercise and diet

Proper exercise and diet may help to improve symptoms. It may be useful to focus on any possible association between certain foods and IBS symptoms. There may be some benefit to adding fiber to the diet.3 Constipation is initially treated with dietary fiber supplements.4

Over-the-counter laxatives

Laxatives may be used for chronic constipation to improve stool frequency, but may not provide relief from abdominal pain.3

Antidiarrheals

Antidiarrheals, like Imodium, are effective at decreasing stool frequency and increasing stool consistency, but may not relieve abdominal pain.3

Probiotics

Probiotics have been shown to reduce IBS symptoms and decrease pain and gassiness in some people with IBS. There also have been reports of improvements in abdominal pain with the use of probiotics. Some probiotics include Latobacillus, Streptococcus, and Bifidobacterium.3

Antibiotics

A course of antibiotics, such as rifaximin, may significantly improve bloating, abdominal pain, and stool consistency. In addition, some people with IBS saw improvements in constipation and overall symptoms.3

Antispasmodics

Antispasmodics, such as hyoscyamine and dicyclomine, may improve abdominal pain and overall symptoms.3

Selective C-2 Chloride Channel Activators

Lubiprostone may be used for constipation predominant IBS for overall symptom relief.3

Antidepressants

Antidepressants may improve abdominal pain and provide overall symptom relief. Antidepressants showing the most benefit include selective serotonin reuptake inhibitors and tricyclic antidepressants.3

Complementary and alternative therapies

Cognitive behavior therapy, relaxation and stress management, and other psychological treatments may be effective in improving IBS symptoms.3

Factors that may negatively affect the outcome4

  • Avoidance behavior related to IBS symptoms
  • Anxiety about related medical conditions
  • Impaired function because of IBS symptoms
  • Long history of IBS symptoms
  • Chronic life stressors
  • Psychiatric conditions
view references
  1. Sayuk GS, Gyawali CP. Irritable bowel syndrome: modern concepts and management options. Am J Med. 2015;128:817-827.
  2. World Gastroenterology Organisation Global Guidelines. Irritable Bowel Syndrome: a Global Perspective. Accessed 1/7/16 at: http://www.worldgastroenterology.org/UserFiles/file/guidelines/irritable-bowel-syndrome-english-2015.pdf
  3. Wilkins T, Pepitone C, Alex B, Schade RR. Diagnosis and management of IBS in adults. Am Fam Physician. 2012;86:419-426.
  4. Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology. 2006;130:1480-1491.
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