While we might all be curious about the best plunger or probiotic tampon or cold-sore remedy, it can be difficult to discuss these more personal items. That’s why we’re tackling Things We Don’t Talk About, a series in which we track down the best hygiene-, sex-, and bodily function–related things we all need but might be too embarrassed to ask about. In this installment, we consult experts on the best IBS remedies.
Irritable bowel syndrome may be one of the trickiest Things We Don’t Talk About. Symptoms are generally unpleasant (and sometimes hard to keep to yourself): they include diarrhea, constipation, gas, bloating, and abdominal pain. And the disorder can be difficult to pin down because it show ups differently from individual to individual.
“With irritable bowel syndrome, there’s not one cause,” says Michelle Cohen, M.D., a gastroenterologist at Mount Sinai. “Each patient is different. We know that there can be abnormal intestinal contractions or occasions where people over-sense things in the gut. Anxiety, depression, hormonal influences, and life experiences could also be factors. And they all come together and create this interaction between the brain and the gut that causes these patient symptoms.”
First, if this all sounds familiar and you haven’t already done so, consult a doctor. “There are things that can mimic IBS that do need other treatments and evaluations,” says Dr. Cohen. But once you’ve identified with your doctor what subset of IBS you might have (constipation-predominant versus diarrhea-predominant, for example) and the severity of symptoms, they might start you on some over-the-counter remedies like the ones below. Here, Cohen walks us through how each of these pills, powders, and foods can ease your symptoms and points us in the direction of which ones are the most effective.
For constipation-predominant IBS, Cohen says, you can start with simple over-the-counter things like fiber or laxatives. “We choose the one the patient might benefit the best from, depending on what their bowel movements are and how often they’re going to the bathroom.” Fiber can mean anything from fiber pills to fiber supplementations with powders like Metamucil.
“In my practice, we tend to use osmotic laxatives (which work by holding water in the stool to soften it), fiber, and stool softeners, and we stay away from stimulant laxatives,” says Cohen, “because a lot of people already have pain and cramping and those can induce and worsen those symptoms.” Popular osmotic laxatives include Miralax, which is the most recommended laxative by doctors, versus a stimulant laxative like Dulcolax, which would be one to avoid.
“If you’re having diarrhea, OTC (over-the-counter) options include fiber to make people bulk up the stool and make it thicker,” says Cohen. “Sometimes you can use OTC anti-diarrhea medication for mild symptoms, though I don’t recommend that anyone start OTC medication without seeing a doctor.”
Pain and Bloating
“In terms of OTC options for pain and bloating, there are certain herbs and food as medicine that can be very helpful. So in my practice, for a lot of pain and bloating, I recommend that people use peppermint, fennel, and ginger in tea form, pill form, oils, or food form,” says Cohen. “Some people even take ginger in the form of ginger candies,” she adds.
Food as medicine is another component of irritable bowel syndrome because it’s influenced by the food you eat. Cohen says that lots of patients have food intolerances on top of IBS so changing their diet can lessen their symptoms. “One diet that’s been very popular recently is called the FODMAP diet. It’s basically a diet of eating foods that have lower amounts of sugar in them so you don’t become as bloated, have less pain, diarrhea. I tend to recommend probiotics as well for people who have bloating and IBS diarrhea.” While there are many FODMAP foods out there, if you want to invest in a good probiotic, this Align probiotic is the top choice that gastroenterologists recommend to IBS patients.
Though the reasons someone with IBS might experience gas could range from being constipated to eating more foods that make you gassy (like broccoli, cauliflower, and brussels sprout), Cohen says that even something as simple as peppermint could be helpful for reducing gas, along with general anti-gas medication that’s over the counter. The most popular anti-gas medication that’s commonly found at drugstores is Gas-X, though here’s a fuller list of the over-the-counter gas medications available, along with reviews.
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