Miralax (polyethylene glycol) has become extremely popular in recent years. It comes in a white powder that dissolves quickly in water or juice.
When you drink the powder, the Miralax is not absorbed into the body, but instead stays in the gut and draws in water, therefore softening the stools and making them larger. (This kind of laxative is called “osmotic” because of its ability to attract water.)
It’s also available in sachets that contain a single dose which are useful if you’re traveling or need to take a dose at work.
Milk of magnesia has been around for so long your great-grandparents might have used it, but sometimes the old remedies are still the best! Commonly sold under the brand name Phillips, this product contains magnesium hydroxide which is another osmotic laxative.
It is generally gentle and is often taken at bedtime to work overnight. The original version has a rather chalky taste, so if you find it unpleasant try the flavored versions in cherry or strawberry or use the chewable tablet version instead.
The most commonly-used anti-diarrheal is Imodium (loperamide) which slows down digestion so that more water can be absorbed from the stools. It’s widely available in capsule form and can also be bought in a soft gel form. Liquid Imodium is available in mint flavor and can be helpful if you want to increase or reduce your dosage very gradually.
Imodium Instants dissolve in the mouth without any extra water needed so are perfect for use when you’re out of the house. A final version (Imodium Multi-Symptom Relief) contains the additional ingredient simethicone which works to break up bubbles of gas and may help to reduce that bloated feeling and stop wind.
Pepto-Bismol contains a different drug (bismuth subsalicylate) and is recommended for diarrhea, indigestion, heartburn, and nausea. It’s most well-known form is as a bright pink liquid, but you can also buy it in tablet, caplet and chewable forms. (It even comes in a bubblegum format for kids!) Check the labels carefully when you’re buying it as the Ultra version is twice as strong as the regular one.
Products like Metamucil and Citrucel can be beneficial because they bulk up the stool and soften it all at once, which can be helpful for both constipation sufferers with hard bowel movements and diarrhea sufferers who need more solid stools.
There are so many different types on the market you might need to try a few before finding your favorite. The most common active ingredients are psyllium husks, methylcellulose, and acacia fiber but other types are available containing various plant and natural fibers and a few synthetic ones as well.
Watch out for added ingredients as some companies add in laxatives to fiber products which you may not want. If you find the powder versions unpleasant to taste, use capsule versions or try Benefiber which should dissolve completely.
It’s usually a good idea to start on a small dose and gradually work your way up to the dose recommended by the manufacturers, as increasing your fiber intake suddenly can cause bloating and gas. Take these supplements with plenty of water, drink plenty more water throughout the day and don’t exceed the recommended dose as too much fiber can cause as many problems as too little.
Using Natural or Home Remedies as an IBS Treatment
Studies have shown that peppermint oil can be helpful in calming an irritated gut. It should be taken in capsules that have an “enteric” coating – this means that the capsules stay intact when they’re in the stomach and only break down and release the peppermint when they reach the intestines where the product is needed most. Heather Van Vorous is an IBS sufferer and sells a suitable product called Heather’s Tummy Tamers which also contain fennel and ginger.
Iberogast is a liquid blend of nine herbs that has been manufactured since the 1960s and is popular in Europe. It includes chamomile, licorice, and peppermint and is advertised as a treatment for all the standard IBS symptoms of constipation, diarrhea, pain, etc. Flaxseed is sometimes recommended for constipation. It can be found either as a ground version or in whole seeds; both of these can be sprinkled on cereal or yogurt.
If constipation is a problem, a number of vitamins and minerals have laxative side effects that you can take advantage of. Vitamin C taken in high doses can have this effect, as can magnesium tablets in a range of forms including citrate and oxide. (Magnesium citrate in a tablet is not the same as liquid magnesium citrate, which is a strong laxative used to empty the bowel before a colonoscopy completely and not for regular use.)
At the opposite end of the scale, if diarrhea is your biggest issue then try a calcium supplement; one common brand is Caltrate Plus, but there are plenty of others available. Calcium carbonate is generally considered the most constipating form of calcium, so try other forms like citrate and gluconate if your diarrhea is relatively mild. The best dosage for both magnesium and calcium when taken for IBS is around 200-450mg per day.
Diet and IBS
I would highly recommend seeking advice from a professional dietician before starting any diet. Not only will they help you choose the best diet to begin with, but they will also help you avoid some common mistakes and pitfalls. (This advice is particularly important to follow if you have suffered from an eating disorder or have other medical issues to consider.)
The FODMAPs diet, for example, often confuses people because it is not one fixed diet that should be followed strictly for the rest of your life. Instead, you start by avoiding a list of high FODMAP foods, but within a few weeks or months you reintroduce different groups of foods, keep a record of how they affect you and end up with a personalized diet plan that works for your own individual symptoms.
A gluten-free or dairy-free diet may be easier to try as long as you study ingredients labels carefully and make sure you know where these products can hide – gluten is found in everything from chips to sausages these days. Gluten is a protein contained in wheat, barley and rye.