Do Over-the-Counter Remedies for IBS Really Work?

Products for Overall Digestive Health

Some products can help relieve digestive distress regardless of whether your primary symptom is diarrhea or constipation. Some of them may aid ​gut motility, improve the bacterial balance in your digestive tract, or soothe hypersensitive or inflamed gut walls.

Popular OTC treatments include:

• Herbal remedies: Peppermint oil, aloe vera, and slippery elm are among the top choices.
• Probiotics: "Friendly" bacteria may balance out "unfriendly" bacteria, reducing pain and severity of symptoms.
• Digestive enzymes: Beta-glucan fiber (from oats and barley) and inositol supplements may significantly reduce abdominal pain, bloating, and flatulence.
• Vitamin D: A deficiency may be linked to IBS symptoms in some people.

It's worth noting that the American College of Gastroenterology's guidelines for 2021 only recommend peppermint oil and probiotics for treating IBS symptoms.

Constipation Remedies

There are several OTC options to consider for relieving constipation that comes with IBS, including:

• Magnesium: Magnesium is a mineral and a natural laxative that can relax intestinal muscles and attract water to soften the stool.
• Laxatives: Several types of laxatives are available that work in different ways. Miralax, Dulcolax, and Metamucil are common brands of laxatives.
• Stool softeners: Designed for short-term use, stool softeners (such as Colace) soften the stool and make it easier to pass.
• Flaxseed: Studies show flaxseed can relieve constipation and diarrhea, thanks to its fiber and anti-inflammatory compounds.
• Triphala: A combination of three fruits purported to be good for the gut, research suggests Triphala can restore the epithelial lining of the digestive tract.
• Atrantil: A dietary supplement designed specifically for constipation-predominant IBS, limited studies suggest Atrantil may reduce bloating and constipation.

The ACG guidelines specifically recommend against the OTC laxative polyethylene glycol (PEG) and don't mention any of the other treatments in this list.

Diarrhea Remedies

These may be used alone or as part of an overall treatment strategy:

• Calcium: Calcium is slightly constipating, and many people with IBS swear by it. Discuss taking supplemental calcium with your healthcare provider, though, because you can get too much calcium.
• Pepto-Bismol (bismuth subsalicylate): The active ingredients of Pepto-Bismol are thought to increase the amount of fluid that is absorbed in the intestines, firming up stool. Side effects can include dark or black stool, constipation, and a black tongue.
• Imodium (loperamide): This drug is often easy to tolerate but can cause side effects including dizziness, drowsiness, nausea, and stomach cramps.

The ACG recommends against loperamide as a first-line treatment for IBS-D because it only addresses diarrhea and doesn't improve other symptoms.

Bloat Remedies

OTC drugs that can relieve symptoms of bloating, like stomach pain, gas, and burping, include:

• Simethicone (common brand names include Gas-X, Alka-Seltzer Anti-Gas, and Mylanta Gas)
• Charcoal capsules
• Beano (alpha-galactosidase)
• Probiotics
• Herbal remedies, including peppermint and chamomile tea, anise, caraway, coriander, fennel, and turmeric

When to See a Healthcare Provider

Consult a healthcare provider if your symptoms are not responding to OTC treatments or if they're getting worse. Also, let them know if you're experiencing additional symptoms, such as unexplained weight loss, heartburn, or changes in stool.