What is the best over the counter medicine for IBS?

Medically reviewed by: Eiman Firoozmand, MD

Over-the-Counter Medicine for IBS: The Top Products for Symptom Relief

Irritable bowel syndrome (IBS) affects over 15% of the population, with women experiencing the disorder twice as often as men. The symptoms of the disorder range from mild to debilitating, causing over 30% of people to experience a low quality of life. 

Unfortunately, despite its prevalence and impact on people’s quality of life, the exact cause of IBS is unclear. And the combination of factors contributing to the disorder’s severity, such as genetics, gut microbiome changes, and stress, make finding treatments harder. 

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However, over-the-counter (OTC) medicines, while not a “cure-all,” can provide relief and make your day-to-day life more comfortable. But are all OTC medicines good for you? And if not, which ones should you take? 

Let’s check out the best OTC IBS medications for symptom relief. 

What is IBS?

Irritable bowel syndrome (IBS) is a chronic irritating disorder that affects the digestive tract. It’s characterized by bloating, belly pain, and changes in bowel habits. The disorder has three types: 

  • Diarrhea (IBS-D)
  • Constipation (IBS-C)
  • Combination (IBS-M) 

The exact cause of IBS is still not fully understood, but it’s believed to involve several factors like abnormal muscle contractions in the intestines, heightened sensitivity to pain, changes in the gut microbiome, and psychological factors like stress and anxiety. More serious conditions should always be ruled out first. Doctors diagnose IBS using a framework known as the Rome IV criteria.

How does IBS affect people?

The symptoms of IBS can vary from person to person, both in severity and presentation. They include diarrhea, bloating, constipation, abdominal pain or discomfort, or a change in stool pattern over time. These symptoms can come and go, with periods of remission and flare-ups.

However, IBS symptoms aren’t limited to the physical, with around 50 to 90% of patients experiencing psychological stress or mental health issues. And people with higher severity of IBS symptoms have higher chances of having anxiety or major depression

Moreover, people with IBS experience a decreased quality of life because the disease can affect their ability to socialize, travel, and work. In fact, surveys reveal that people with IBS miss an average of 13.4 days of school or work every year compared to 4.9 days for those without the condition. 

Plus, IBS symptoms can lead to 14 hours of productivity loss (out of a 40-hour workweek) and avoidance of day-to-day activities like household chores, exercise, traveling, eating out, and going to unfamiliar or new places. 

Is there any cure for IBS?

A “cure” is a treatment that eliminates a disease from your body and prevents it from returning. However, when it comes to conditions like IBS, finding a permanent cure is difficult. 

That’s because IBS is a combination of various functional changes in the body, including altered gut sensitivity, abnormalities in bowel movements and secretions, and changes in brain function. 

Studies examining these factors have produced inconsistent results, and the underlying causes of IBS often do not directly correlate with specific gut symptoms. This suggests that IBS may have different subgroups, each requiring unique clinical diagnosis and management approaches — meaning finding a “cure-all” for all forms of IBS may not be possible.

So, the goal of IBS treatment is to treat individual symptoms and try to improve the overall well-being of the patient. That’s where OTC medicines come in.  

What are over-the-counter (OTC) medicines?

Over-the-counter medications can be purchased directly from a pharmacy or retail store without a prescription. Available as tablets, capsules, liquids, creams, ointments, and sprays, they’re intended for the self-treatment of common disorders and symptoms. 

While OTC medicines are available to anybody, they are regulated and approved by regulatory authorities like the FDA to ensure their safety and effectiveness when used as directed. 

Over-the-counter medicines for IBS symptom relief

Picking the right over-the-counter (OTC) medication for treating IBS symptoms can be tricky. To help you out, we’ve created a list of research-backed options based on the specific symptoms you may be experiencing. Let’s check it out:

1. Constipation 

You’re considered constipated if you have fewer than three bowel movements per week, resulting in hard and lumpy stool. And while eating raw fruits and vegetables may help some people relieve their symptoms, it may not improve constipation associated with IBS. 

That’s because IBS-related constipation can be caused by issues like impaired intestinal motility and activity. In these cases, the following OTC medications can be helpful in managing constipation:

a. Psyllium 

Psyllium husk is a soluble fiber with a high water-holding capacity, which is particularly beneficial in the best diet for IBS, holds water better than insoluble fiber and helps in relieving constipation. 

The fiber also has a good gel-forming capacity that makes it viscous, enabling it to travel smoothly through the gastrointestinal system. This improves gut transit time and regulates bowel movements. 

Psyllium husk is available over the counter as Metamucil and must be taken in higher dosages, like 20 to 25 grams/day, to have optimum effect. However, while psyllium supplementation is safe, you may experience temporary abdominal pain or bloating if taken too rapidly. 

b. Laxatives 

Laxatives help improve bowel function and provide relief from severe constipation. They are commonly used as a treatment option for IBS-C since they help speed up the elimination of waste from the body.

For instance, a randomized trial with 42 IBS-C patients using polyethylene glycol (PEG) for 30 days showed a significant increase in bowel movements and IBS symptom relief. Similarly, another four-week study with 139 IBS-C patients found an increase in spontaneous bowel movements with PEG. 

While limited in scope, these studies suggest that PEG might effectively improve bowel movement frequency in patients with IBS-C. Some OTC laxatives with PEG include Correctol and Miralax.  

c. Stool softeners 

Constipation can mean different things to different people, and that can cause them to need different treatments. For instance, if you’re experiencing bowel movements once every week, a laxative may be more helpful to you. 

However, if you’re emptying your bowels once every day, but it’s too “hard,” a stool softener might be ideal for you. That’s because stool softeners stimulate water absorption and make passing stool much easier. 

Docusate sodium is a stimulant-free OTC stool softener used to relieve occasional constipation and promote regular bowel movements. It works by drawing water into the intestines, softening the stool, and making it easier to pass. 

The drug usually takes 6 to 12 hours to provide full effects. However, it’s important to consult with your doctor if you have any underlying health conditions, are taking other medications, or if constipation persists.

2. Diarrhea 

When stool travels through the large intestine, it becomes solid as water is reabsorbed. In the case of IBS with diarrhea (IBS-D), the stool moves too quickly, which doesn’t leave enough time for solidification. 

This can lead to bloating, abdominal pain, frequent bowel movements, loose, watery stools, and cramping. So, IBS patients with chronic diarrhea want to make their stool bulkier and slow down the process. Here are some OTC medicines you can use to improve diarrhea:

a. Calcium polycarbophil (FiberCon)

Calcium polycarbophil (FiberCon) is an OTC bulk-forming laxative used to relieve symptoms of various gastrointestinal conditions, including constipation. It works by absorbing water in the intestine, forming a gel-like substance that adds bulk to the stool, reducing diarrhea.  

FiberCon is considered safe for long-term use and has been shown to decrease bowel movement frequency, increase colonic transit time, and reduce abdominal pain. It is available in various forms, such as tablets or powder. 

b. Loperamide (Imodium A-D)

Imodium is a commonly used over-the-counter antidiarrheal that works by increasing water absorption, reducing the speed of stool movement and improving stool consistency.

It contains loperamide to address diarrhea and simethicone — which causes bubbles in the intestine to burst or combine with bigger ones so they can be absorbed by the intestinal wall — to relieve gas and bloating. 

Both drugs have been shown to lead to significant bowel movement improvements. For example, in a randomized, double-blind study, a combination of loperamide with simethicone decreased the abdominal discomfort relief time from 42 hours with loperamide alone to 12 hours and led to the relief of pain and bloating. 

However, loperamide shouldn’t be taken if you have antibiotic-related diarrhea, Crohn’s disease, or bacterial inflammation in the intestine. It can also have the following side effects: 

  • Headache 
  • Dizziness
  • Rash 
  • Vomiting 
  • Dry mouth
  • Heartburn 
  • Nausea
  • Gas and abdominal pain 
  • Bloating.  

So, consult with your doctor before taking loperamide. They’ll help you figure out the correct dosage and frequency. 

3. Gas and bloating 

Gas and bloating are caused by inefficient gas transit, increased gas production due to bacterial fermentation, dysfunctional intestinal muscles, and heightened sensitivity of the gut to normal gas volumes. 

They were considered one of the most bothersome symptoms by at least 60% of IBS patients in a survey. And more than 90% of IBS patients report they suffer from bloating and gas. If you’re dealing with gas and bloating, here are some OTC medicines you could take: 

a. Iberogast

Iberogast is a herbal formulation containing a blend of various plants like peppermint oil and chamomile, known for their ability to improve abdominal discomfort

It works by influencing the movement of your gastrointestinal tract and relaxing the smooth muscles in your intestines. This can help alleviate muscle spasms and abdominal pain. 

b. Gas-X

Gas-X is an OTC medication used to relieve symptoms of gas, bloating, and discomfort caused by excess gas in the stomach and intestines. It contains simethicone, which breaks down large gas bubbles into smaller ones, making them easier to pass and relieving discomfort. It can be used as chewable tablets, soft gels, or strips.

OTC medicines for IBS: final thoughts 

While there is no cure for IBS, OTC medications can effectively help you manage symptoms associated with the disorder. 

Drugs like psyllium, laxatives, and stool softeners can help regulate bowel movements if you’re experiencing constipation. Similarly, calcium polycarbophil (FiberCon) and loperamide (Imodium A-D) are effective in reducing diarrhea symptoms. 

However, before using OTC medicines, consult with your doctor to determine the right medication and dosage for your needs. 

Frequently asked questions about over-the-counter (OTC) medicines for IBS

Can you treat IBS without medicines?

Yes, you can treat IBS without medicines but it depends on a case-by-case basis. For instance, your doctor may ask you to find support for IBS, increase your dietary fiber intake and activity levels, and use relaxation techniques to manage stress before moving to drugs like selective serotonin reuptake inhibitors. 

What are the signs you need a different treatment for IBS?

IBS symptoms can change over time, with periods of IBS flare-ups followed by those of remission. It’s also possible for someone to transition from one subtype of IBS to another. 

For instance, someone initially diagnosed with IBS-C (constipation-predominant) may later experience symptoms characteristic of IBS-M (mixed subtype). 

Talk to your doctor if you experience a shift in symptoms, such as from constipation to diarrhea or vice versa. They can look at your treatment plan and suggest any necessary changes, including lifestyle and medication modifications.

It’s also important to note that sometimes, people are misdiagnosed with IBS when they actually have a rare condition like celiac disease. In these cases, your IBS symptoms will persist despite optimal IBS treatment and you’ll need to undergo course correction for symptom relief.

Do probiotics help with IBS?

Probiotics — which are one of the common alternative therapies for IBS — improve intestinal immunity, cause the production of essential nutrients, lead to toxin elimination, prevent microbial translocation (i.e., when bacteria move from the large intestine to the small), and improve stool consistency. 

However, they have to be consumed in sufficient amounts, and different bacterial strains, such as Lactobacillus plantarum, Bifidobacterium, and Streptococcus, can lead to different effects. 

How long does it take for irritable bowel syndrome to heal?

IBS is a long-term disorder and can have symptoms that occur in cycles extending for days, weeks, or even months. This means the disorder typically persists throughout your lifetime, causing you to need ongoing management and care.

What happens if IBS goes untreated?

Irritable bowel syndrome (IBS) is not considered a life-threatening condition. However, if left untreated, it can contribute to the development of conditions like hemorrhoids and mood disorders. It also has a range of complications that can significantly reduce the quality of life of IBS patients.

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