High fiber diet. Critical. It has been well documented that a diet rich in insoluble fiber is essential in controlling IBS diarrhea. The most effective is wheat bran. I use wheat bran in some biscuits I make. By eating two biscuits a day I receive my daily dose of insoluble fiber and that has totally eliminated my diarrhea. Other good sources are Shredded wheat and Fiber Oone cereal. Always start will low doses of fiber and work up or it can cause bloating.
Peppermint products like lozenges, peppermint oil and candy can help relax the stomach as well. Be sure it contains real peppermint and not just artificial flavoring. Peppermint relaxes smooth muscles like the ones in the stomach. Caution - It also relaxes the lower esophageal sphincter (the valve at the top of the stomach) which can lead to heartburn.
I was put on prescription dicyclomine. Very little benefit.
Prior to using the wheat bran fiber I also took Imodium which seemed to be effective BUT if not careful I would become constipated. I found that I could take a small grain of it (about the size of a large grain of sand) everyday and it would help my diarrhea a lot.
Last but not least. Heartburn. People with IBS often develop chronic heartburn, especially when they get older. Many times this heartburn takes the form of LPR (Laryngopharyngeal Reflux). this is an unusual reflux in that it does not have the classic heartburn symptom. The acid coming up into the esophagus will burn the throat and the sinus cavities leading to a sore throat and postnasal drip. If this occurs there is some tips below that may help.
Heartburn
TREATMENT—
• Immediately drink a large glass of water. This will help wash the HCl back down and dilute it as well.
• Do not lie down. Remain upright, so gravity can help push the HCl down and keep it down. Later, when you do lie down, elevate the bed at the head by 4 to 7 inches.
• Avoid bending over; if you must lift something, bend at the knees. You do not want to compress your stomach when you have heartburn.
• Eating mints relaxes the lower esophageal sphincter, so HCl can crowd up into the esophagus.
• Do not drink anything caffeinated, for it will irritate the esophagus even more. Caffeine relaxes the sphincter, so stomach contents can move on up. Tobacco smoke also relaxes the sphincter. Estrogens relaxs it also.
• Drinking milk may feel good going down, but it encourages the stomach to secrete more acid.
• Drinks with fizz in them expand the stomach and make it more likely that HCl will come up the food pipe.
• Greasy, fried, and fatty foods sit in the stomach for a long time and increase HCl production. Avoid meat and dairy products.
• Antidepressants and sedatives aggravate heartburn. Aspirin and ibuprofen cause heartburn.
• Avoid stress, for that increases HCl production also.
• Loosen your belt; better yet, wear suspenders.
• Do not eat within 2½ hours before bedtime. Doing so not only can cause heartburn, but bring on heart attacks also.
Gargle with baking soda water. Baking soda neutralizes stomach acid. Sipping baking soda water will neutralize acid in the throat and stomach but drinking too much can cause gas which can force more acid into the throat.
My drs have instructed me that at the first sign of LPR start on omeprozole (Prilosec OTC). It should correct the LPR in 2 to 4 weeks. I have found it to be very effective..