Treatment of IBS focuses on relieving symptoms so that you can live as symptom-free as possible.

Mild symptoms can often be controlled by managing stress and by making changes in your diet and lifestyle. Try to:

• Avoid foods that trigger your symptoms
• Eat high-fiber foods
• Drink plenty of fluids
• Exercise regularly
• Get enough sleep

Your provider might suggest that you eliminate from your diet:

• High-gas foods. If you experience bloating or gas, you might avoid items such as carbonated and alcoholic beverages and certain foods that may lead to increased gas.
• Gluten. Research shows that some people with IBS report improvement in diarrhea symptoms if they stop eating gluten (wheat, barley and rye) even if they don’t have celiac disease.
• FODMAPs. Some people are sensitive to certain carbohydrates such as fructose, fructans, lactose and others, known as FODMAPs — fermentable oligosaccharides, disaccharides, monosaccharides and polyols. FODMAPs are found in certain grains, vegetables, fruits and dairy products.

A dietitian can help you with these diet changes.

If your problems are moderate or severe, your provider might suggest counseling — especially if you have depression or if stress tends to make your symptoms worse.

Based on your symptoms, medications may be recommended, including:

• Fiber supplements. Taking a supplement such as psyllium (Metamucil) with fluids may help control constipation.
• Laxatives. If fiber doesn’t help constipation, your provider may recommend over-the-counter laxatives, such as magnesium hydroxide oral (Phillips’ Milk of Magnesia) or polyethylene glycol (Miralax).
• Anti-diarrheal medications. Over-the-counter medications, such as loperamide (Imodium A-D), can help control diarrhea. Your provider might also prescribe a bile acid binder, such as cholestyramine (Prevalite), colestipol (Colestid) or colesevelam (Welchol). Bile acid binders can cause bloating.
• Anticholinergic medications. Medications such as dicyclomine (Bentyl) can help relieve painful bowel spasms. They are sometimes prescribed for people who have bouts of diarrhea. These medications are generally safe but can cause constipation, dry mouth and blurred vision.
• Tricyclic antidepressants. This type of medication can help relieve depression, but it also inhibits the activity of neurons that control the intestines. This may help reduce pain. If you have diarrhea and abdominal pain without depression, your provider may suggest a lower than typical dose of imipramine (Tofranil), desipramine (Norpramin) or nortriptyline (Pamelor). Side effects — which might be reduced if you take the medication at bedtime — can include drowsiness, blurred vision, dizziness and dry mouth.
• SSRI antidepressants. Selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (Prozac) or paroxetine (Paxil), may help if you are depressed and have pain and constipation.
• Pain medications. Pregabalin (Lyrica) or gabapentin (Neurontin) might ease severe pain or bloating.