The Gastroenterologist. For some, IBS has an infectious origin, so treating it with antibiotics like Xifaxan that act on bacteria in the intestinal tract may help. Ask your doctor about probiotics. If taken regularly, they can help promote growth of healthy bacteria and overcome bad bugs that can cause gas, bloating and other symptoms. Try Dannon Activia yogurt or Digestive Advantage supplements.
— Robert Yatto, MD, Crossville, Tennessee
The Neurogastroenterologist. Many people with IBS have a problem with serotonin, a chemical messenger that’s produced in the gut, so drugs that work on serotonin can help. (Editor’s note: The original version of this story suggested that people who have IBS with constipation try the drug Zelnorm. That drug is no longer being marketed because of evidence suggesting it may raise the risk of heart attacks and strokes.) The drug Lotronex is best for IBS with diarrhea. It can also take away pain, bloating and discomfort.
— Michael Gershon, MD, Professor, Columbia University, New York, New York
The Nutritionist. Lactose and fructose can trigger symptoms in some. Both can cause cramping, bloating and diarrhea if you don’t have the enzymes to digest and absorb them; cutting back may help. Limit hard-to-absorb sugar alcohols like maltitol and xylitol (often found in sugar-free or low-carb foods). Fiber supplements can help ease constipation, but talk to your doctor before making any dietary changes.
— Dwight McKee, MD, Aptos, California
The Psychologist. Irritable bowel is often related to anxiety. After your doctor has ruled out other problems, a trained hypnotherapist can help you learn how to enter a deep state of relaxation, which can ease bloating, pain, diarrhea and constipation (find a therapist at ibshypnosis.com). Hypnosis can begin to work in as few as two sessions, and can be done in conjunction with drugs and other lifestyle approaches.
— Edward A. Schechtman, PhD, President, New York Society of Clinical Hypnosis
Some people spend their entire lives with abdominal pain, bloating and constipation and never tell their physicians. Talk to your doc! Solutions can be as simple as increasing water and fiber intake (25 grams daily), or trying probiotics. If symptoms persist, testing for more serious causes is warranted. Drugs that treat underlying problems can help too.