Irritable bowel syndrome (IBS) treatment focuses on managing symptoms such as abdominal pain, diarrhea, constipation, and changes in bowel movement patterns. The best approach depends on the specific symptoms you experience. Treatments may include medications, dietary changes, probiotics, and mental health therapies.

Since IBS often affects both gut function and mental well-being, many treatment plans address both digestive health and conditions like anxiety or depression, which can influence symptom severity. No single treatment works for everyone, so a gastroenterologist will help create a personalized plan.

Medications

Healthcare providers typically recommend dietary and lifestyle changes before prescribing medication. The choice of drug depends on whether diarrhea, constipation, or abdominal pain is the primary concern.

Antidiarrheal medication may be used if food moves too quickly through the digestive system, preventing proper water absorption. Options include:

  • alosetron (lotronex) – slows stool movement and is approved for severe IBS with diarrhea

  • eluxadoline (viberzi) – reduces bowel activity

  • loperamide – available over the counter or by prescription to slow digestion

  • rifaximin (xifaxan) – an antibiotic used for specific IBS cases

Laxatives and stool softeners help with constipation, defined as fewer than three bowel movements per week or hard, dry stools. Options include:

  • linaclotide (linzess) – speeds up intestinal movement

  • fiber supplements – available over the counter

  • OTC laxatives – mild options for occasional constipation

  • plecanatide (trulance) – promotes bowel movements

  • lubiprostone – a prescription laxative for certain IBS cases

Medications for abdominal pain may be recommended when cramping and discomfort are primary symptoms. These include:

  • antidepressants – such as selective serotonin reuptake inhibitors (SSRIs)

  • antispasmodics – reduce muscle spasms in the gut (short-term use)

  • peppermint oil supplements – may help relax intestinal muscles

Lifestyle Changes

Keeping a food journal can help identify foods that trigger symptoms. Working with a healthcare provider or dietitian can make it easier to replace trigger foods with better options.

Dietary changes may include:

  • avoiding gluten – found in wheat, rye, and barley

  • increasing fruits and vegetables – to boost fiber intake gradually to 22–34 grams per day

  • trying a low-FODMAP diet – limiting certain hard-to-digest carbohydrates found in dairy, wheat, beans, and some fruits and vegetables

Other beneficial habits include getting enough sleep, reducing stress, and increasing physical activity. Regular exercise has been shown to improve IBS symptoms for some people.

Probiotics

Probiotics are live microorganisms that may benefit gut health. They are naturally found in fermented foods like yogurt and kefir or taken as supplements.

The effectiveness of probiotics for IBS varies based on the strain, dosage, and individual response. While some people find them helpful, current evidence is not strong enough to recommend them universally. Always consult a healthcare provider before starting probiotics, especially if you take other medications.

Mental Health Therapies

Because the gut-brain connection plays a role in IBS, addressing mental health can improve symptoms. IBS is often linked to depression, anxiety, and stress, which can trigger flare-ups.

Therapies that may help include:

  • antidepressants – such as tricyclic antidepressants or SSRIs for pain relief

  • cognitive behavioral therapy (CBT) – helps change thought patterns and behaviors around symptoms

  • gut-directed psychotherapy or hypnotherapy – focuses on relaxation and improving brain-gut communication

  • mindfulness practices – such as meditation to manage stress

Living With and Managing IBS

While IBS treatments can significantly reduce symptoms, the condition can still affect daily life. Pain, bloating, and unpredictable bowel habits may limit activities and increase stress.

Ways to cope include:

  • avoiding excess caffeine

  • reframing negative thoughts about symptoms

  • exercising regularly

  • eating a balanced, nutrient-rich diet

  • tracking stressors to reduce their impact

  • keeping a consistent sleep schedule

  • seeking support from friends, family, or healthcare professionals

A Quick Review

IBS treatment may include medications, dietary adjustments, probiotics, and mental health therapies. The right combination varies for each person. A gastroenterologist can help design a plan to control symptoms and improve quality of life.