Drug Therapy

Drugs to reduce bowel spasm have been used for many years. They are generally very safe and often worth trying. They are mostly available without a prescription and your pharmacist will be happy to advise you. Unfortunately they only benefit a relatively small number of patients. As we begin to learn more about how our intestines work, new drugs are being developed, some of which may help patients whose main symptom is diarrhoea and others who tend to be constipated. Some of these newer agents are not yet available to doctors to prescribe but it does seem likely that a wider range of treatments will be available to patients with IBS in the near future.

Sometimes when pain is a major problem, small doses of drugs which are used as antidepressants – such as amitriptyline – can be helpful. These can be useful in patients who have no signs of being depressed. 

What other treatments are available?

Hypnotherapy and relaxation therapy have been tried and both have been shown to be effective. Hypnotherapy can be obtained through approved therapists who should be members of the British Medical Hypnotherapy Association. Your doctor may advise on counselling, and some specialists believe that a psychological treatment called cognitive behavioural therapy (CBT) can be useful.

Are there alternative therapies?

There are indeed many alternative therapies, although none of them has been very carefully assessed in the manner that doctors use to ensure that their treatments are indeed effective. Some patients certainly find that herbal remedies can be helpful but at present there isn’t enough evidence to be sure about this. Aromatherapy and other forms of relaxation can help to relax you, but again we do not know whether they improve bowel symptoms. Many doctors are wary of recommending what they see as unorthodox or unproven treatments although few will object if you wish to try alternative medicines.

What research is needed?

The most important question for researchers in IBS is to find out what causes the condition. Knowing this will enable more rational and more effective treatments to be developed. As more and more is revealed about the causes of IBS, it is likely that different patterns of symptoms that patients describe will require differing approaches to treatment. In addition, we need to know more about the mechanism by which specific foods cause IBS as well as how psychological factors can unsettle our insides.