What’s the Best Way to Treat I.B.S.?

Irritable bowel syndrome is one of the most common and perplexing conditions gastroenterologists treat. It affects an estimated 6 percent of people in the United States, with more women diagnosed than men, and causes symptoms so debilitating they can be hard to ignore, including abdominal pain, bloating, diarrhea and constipation.

Scientists don’t know exactly what causes I.B.S., and there is no cure, so the condition is often difficult to manage.

But a new study, published today in the journal The Lancet Gastroenterology and Hepatology, offers clues for how best to find relief.

What is I.B.S.? How is it usually treated?

The telltale symptoms of I.B.S. are chronic abdominal pain, along with diarrhea, constipation or both, said Dr. Brian Lacy, a gastroenterologist at the Mayo Clinic in Jacksonville, Fla. Bloating is also a common complaint, he said.

Treatments often include managing the symptoms with changes to your diet or taking medications, which can include over-the-counter laxatives and antidiarrheals; certain antidepressants; and other prescription medications, like linaclotide and lubiprostone, both of which can increase fluid in the gut and the movements of your intestines. Yet few studies have examined whether dietary changes or medications are best for relief.

The most robust research available on dietary strategies has found that following a low-FODMAP diet — which involves avoiding foods like wheat-based products, legumes, some nuts, certain sweeteners, most dairy products and many fruits and vegetables — can reduce I.B.S. symptoms in most people, said Dr. William Chey, a gastroenterologist at Michigan Medicine.

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