Some commonly prescribed medications for irritable bowel syndrome or IBS are dicyclomine (Bentyl) for muscle spasms, hyoscyamine (Levsin , Levbid) anti-spasmodic. Nexium, Prevacid, Prilosec, omeprazole (Zegrid), pantoprazole (Protonix) and Aciphex all acid blockers. A wide variety of laxatives, stool softeners and constipation agents are also prescribed. These are considered standard treatments by GI and primary care doctors for either diarrhea or constipation predominant IBS.
An expensive antibiotic (up to $1100 per month) called rifixamin (Xifaxan) is starting to be used for some cases of IBS in the research, however it is only approved by the FDA at this time for travelers diarrhea. Other than eat more fiber there is usually very little dietary advice. These medications may provide some temporary relief from the symptoms but do very little to address the underlying causes of irritable bowel syndrome.
From a Functional Medicine perspective, the first treatments should be dietary changes. I give a long list of foods to avoid such as all dairy, wheat, corn, white sugar, white flour, all fast foods, microwave foods and more. We also give a longer list of good foods, and easy to fix meals so no one goes hungry. Many people will have amazing improvement in their symptoms after just four weeks on a “clean” diet. Gradually we will add back some foods, one at a time, and monitor for reactions. Then people know what really bothers them.
These simple dietary changes can begin to change the composition and quality of the bacteria in the gut in a more “friendly” direction. I may also recommend a strong probiotic or specialized fiber supplement containing a pre-biotic or what I call “fertilizer” because it helps good bacteria to grow. Quoting Hippocrates: ” Let food be thy medicine and medicine be thy food”. These are the “medicines” that get to the causes of irritable bowel syndrome.