How is the IBS pain treated?
Sometimes giving a diarrhoea patient, anti-diarrheal will help their pain. And giving a patient a laxative or constipation medication may help their pain. But it doesn't necessarily do that, because patients have this hyper sensitivity of their gut. So often you want to treat the patient specifically for the pain. One of the more common medications to use is a group of medications called the tricyclic agents. Now previously they were used at high doses for anxiety and depression, but there are newer medications to treat that. And they are associated with a high degree of side effects. We currently use tricyclic agents as analgesic agents or to decrease pain. And it's not only for the bowel. You can use it for patients who have nerve pain. Like herpes is ostrorelated nerve pain or diabetic neuropathy. It's used for fibromyalgia. So it's really a general analgesic agent at a low dose. Where it doesn't actually treat mood. So these medications include Desipramine, which has actually been studied well in irritable bowel syndrome. Amitriptyline and Nortriptyline are commonly used. They do have side effects. So for example Amitriptyline is commonly used for sleep disorder. So if you have an IBS patient that doesn't sleep well and you want to restore their sleep, Amitriptyline might be a good choice, because not only does it restore sleep, it can treat their pain that's associated with their IBS. Now another class of agents to use is the SSRI's. Which are Selective Serotonin Reuptake Inhibitors. And those are FDA approved for the treatment of depression and anxiety. You're not necessarily always treating mood, although if you treat mood that's good because it can also help the management of their symptoms. But there is evidence, recent evidence that's shown that treatment with SSRI's actually improve bowel symptoms and pain irrespective of their effects on mood.
