There are a couple of different types of treatment methods for IBS. Depending on what you and your doctor decide is best, you might try any combination of these or specific areas. Treatment tends to focus on either improving your body’s pain sensitivity. So an effort to turn down the gain or just make your brain not focus on pain, or decreasing the things that make your intestine stretch out. Improving vagal tone is one of the main mechanisms we use to improve pain and to decrease sensitivity to pain. And we can use things like transiricular stimulations, there’s a device called IB-STIM that you wear on your ear. We can use medications like SSRI, TCAs, or a medication called Remeron. This is how things like biofeedback or cognitive behavioral therapy help. It’s all methods to help you process pain so that it doesn’t bother you to the same extent and to disassociate pain from worrying about things, so that pain doesn’t make you feel anxious, or like there’s a problem that you have to address.
To decrease stretch, we can try a variety of things like the low FODMAP diet. This is a diet where you avoid certain things that bacteria in your intestines turn into gas. We can use medications like laxatives. There is a medication called linaclotide that’s particularly great for this if you have the constipation version. If you have the diarrhea version, we will sometimes try something called eluxadoline. And in some cases we will use Loperimide or Immodium. Lastly, sometimes we’ll use things like antibiotics to try to clear out the bacteria in your intestines so that they cannot produce gas or use medications that help that are called anti-spasmodic to make it so that the movement of your intestines is a little bit more smoothed out.