How can I manage the pain?

Pills

Here are some self help methods we would recommend.

Bowel Directed Relaxation.
Deep steady breathing.
Listen to music.
Watch a film.
Phone a friend
Take a hot bath
Cradle a hot water bottle
Therapeutic massage.
Hypnotherapy, yoga and meditation.
Over the counter medications

Antispasmodic medication

Antispasmodic drugs relax the muscles of the gut, relieving the spasm and distension that causes pain. Some such as Buscopan and Merbentyl may have associated side effects such as a dry mouth and blurred vision and difficulty passing water.

	Generic Name	Brand Name
	Hyoscine	Buscopan
	Dicyclomine	Merbentyl
	Alverine Citrate	Spasmanol, Alvercol
	Peppermint Oil	Colpermin, Mintec
	Mebeverine Hydrochloride	Colofac

Although hyoscine and dicyclomine are strong antispasmodics, some patients may experience side effects with them. These include dry mouth, blurring of vision and urinary retention.

Antispasmodic medication can be purchased over the counter at your local pharmacist.

Antidepressants

“Low dose antidepressants can relieve IBS pain when analgesics fail.”

Pain that is resistant to antispasmodics may respond to treatment with low doses of antidepressants. This may be partly due to the alleviation of an underlying depression and partly because of a direct effect on pain pathways in the gut. Anxiety and depression can make people more sensitive to pain and can upset the bowels.

There are two classes of drugs.

	Genric Name	Brand Name
	Amitryptyline	Tryptizol
	Nortryptyline	Doxepin
	Dothiepin Hydrochloride	Prothiadin

* Tricylic antidepressants tend to make constipation slightly worse.

	Generic Name	Brand Name
	Fluoxetine	Prozac
	Sertraline	Lustral
	Paroxetine	Seroxat
	Citalopram	Cipramil

*SSRIs can make the bowels more loose and may be more useful in people with constipation.
Antidepressants can only be obtained on prescription.

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