When it comes to medications and supplements the internet is full of creative promises and magic wands. Unfortunately, many of these hold little science to support them and are nothing more than marketing. Below is a list of medications and supplements that can be purchased over the counter which have good evidence that they may help with managing IBS symptoms. Of course, this information is general in nature and does not replace advice provided by your healthcare team. Please discuss your needs with your doctor before making any major changes.
The low FODMAP diet has been shown to help 3 out of 4 people with IBS manage their symptoms through diet. As a dietitian, I tend to use a “food first” approach the majority of the time. This usually means getting back to basics to help people work out how their body responds to food before adding in medications or supplements. Of course, we also know that IBS is influenced by multiple factors; including food, stress levels, pelvic floor strength, gut transit, gut microbiome and more. This means that using a range of different techniques in your IBS tool box can give great results.
PHGG (ProNourish natural fibre balance or Sunfiber): (FODMAP certified) These are soluble fibre supplements that act like a sponge and soak up water. This helps to make loose stools more formed and firmer stools bulkier/softer and easier to pass. These can be effective for both constipation and diarrhoea depending on the dose taken. There is evidence that soluble fibre is also beneficial for general gut health, heart disease, diabetes and cholesterol
Metamucil/Fibogel/Psyllium: (Appears well tolerated in IBS): This is a soluble fibre supplement acts like a sponge, soaking up water. This helps to make loose stools more formed and firmer stools bulkier/softer and easier to pass. Metamucil can be effective for both constipation and diarrhoea depending on the dose taken. There is evidence that soluble fibre is also beneficial for general gut health, heart disease, diabetes and cholesterol
Oat bran, linseeds: Food options that may improve constipation, abdominal pain and bloating in people with IBS.
Kfibre: (FODMAP certified) This is an insoluble fibre which is particularly helpful for constipation, reflux and general gut health. If you purchase Kfibre from their website, the code gutlove10 for will give 10% off.
Citrucel/Normafibre: May be helpful for constipation and has been shown to be well tolerated in IBS.
Osmotic laxatives: e.g. Movicol, Osmolax. These act by drawing water into and lubricating the digestive tract. This is helpful for constipation and can be used long term.
Stimulant laxatives: e.g. Dulcolax, Senna & Coloxyl. These work by increasing contractions along the digestive tract pushing matter through. These are not advised for long term use.
Gastro stop, Immodium: These are effective for short term management of diarrhoea. They can cause constipation. These are not recommended for long term use. If symptoms persist please consult with your doctor or dietitian.
Mintec/Peppermint oil capsules
These have an enteric coating so that they survive the acidic pH in the stomach and travel to the bowel. They act by relaxing smooth muscle and aiding in managing flatulence.
This is a herbal supplement that has evidence to support its efficacy in IBS. It helps by regulating contractions in the stomach and may be calming to the nerves. Iberogast is shown to work best taken regularly.
May be helpful for relaxing muscle spasms and for managing constipation. Magnesium also acts as an osmotic laxative.
Simethicone e.g. degas
Allows gas in the intestines to come together more easily. Makes gas easier to pass and may relieve painful pressure in the digestive tract.
This is an antispasmodic and may help with managing cramps.
Given the variation of gut microbiome form person to person, Probiotics will behave differently in different people. They may help, they may do nothing and they may make symptoms worse. If you choose to trial probiotics, please discuss which options are likely to be best for you with your doctor or dietitian. You can read more about probiotics and IBS here.
Please note that I have not included prescription medications in this list.