Irritable bowel syndrome (IBS) is a problem that affects the large intestine. It can cause abdominal cramping, bloating, and a change in bowel habits. Some people with the disorder have constipation. Some have diarrhea. Others go back and forth between the two.
Irritable bowel syndrome (IBS) and chronic idiopathic constipation (CIC) are among the most common conditions seen by gastroenterologists. Selecting appropriate therapies for patients with these disorders is complicated because there is not one specific disease-causing mechanism and patients often suffer from a broad range of nonspecific symptoms.
Diarrhea-predominant IBS (IBS-D)
Evidence-based approaches to managing diarrhea-predominant IBS (IBS-D) include dietary measures, such as a diet low in gluten and fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs); loperamide (Imodium™); antispasmodics; peppermint oil; probiotics; tricyclic antidepressants; alosetron (Lotronex ™); eluxadoline (Viberzi™), and rifaximin (Xifaxan™).
Constipation-predominant IBS (IBS-C)
Evidence-based approaches to managing constipation-predominant IBS (IBS-C) and CIC include fiber, stimulant laxatives, polyethylene glycol (Miralax™), selective serotonin reuptake inhibitors, lubiprostone (Amitiza™), and the guanylate cyclase agonists plecanatide (Trulance™) and linaclotide (Linzess™).
Treatment of IBS
As this list makes clear, treatment approaches can be as varied as the symptoms patients may have. It is also important that other diagnoses are properly considered, such as celiac disease and gluten sensitivity, and SIBO (small intestinal bacterial overgrowth).
Dr. Klaus Gottlieb in Templeton, CA, has extensive experience in the treatment IBS (Irritable Bowel Syndrome) and constipation, and was the study director for “A Study of the Effect of SYN-010 on Subjects With IBS-C” and has published research about the connection of elevated intestinal methane with IBS-C.
Gottlieb, Klaus., et al. “Inhibition of methanogenic archaea by statins as a targeted management strategy for constipation and related disorders.” Alimentary pharmacology & therapeutics 43.2 (2016): 197-212.
More info about IBS at Medlineplus