Can Gabapentin be used to treat irritable bowel syndrome? (IBS)

By Ask Your Pharm
Page last updated: 27/01/2024 | Next review date: 27/01/2026
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In this article, we will answer the question “Can Gabapentin be used to treat irritable bowel syndrome (IBS)? We will also discuss what the research suggests, dosage recommendations of Gabapentin for IBS, potential side effects and what to do if Gabapentin does not help your IBS.

Can Gabapentin be used to treat irritable bowel syndrome?

Yes, Gabapentin can be used for the treatment of irritable bowel syndrome. Although it is not the first line of treatment, it is used to relieve the pain caused due to IBS.

One of the main symptoms of IBS is abdominal pain which can differ in the extent and varies from person to person. Diarrhoea, constipation and bloating are also common among the people who suffer from IBS. (1) The pain can be severe in some cases and can trigger anxiety episodes. (2)

The research studies that have been conducted concluded that Gabapentin is effective in increasing the tolerance of pain caused due to irritable bowel syndrome.

What does the research suggest?

A research study suggests that gabapentin increases the toleration capacity of pain, bloating and discomfort. (3)

A study done in 2014 revealed that gabapentin can also reduce systemic anxiety associated with IBS. (4)

A study done in 2017 indicated that gabapentin along with other medications can be considered quite effective in managing the symptoms related to IBS. (5)

Dosage recommendations of Gabapentin for IBS

The dose of Gabapentin for IBS is usually started with 300mg per day for the first three days and then the dose is increased to 600mg per day for the subsequent two days. The maximum dosage can go up to 4800mg per day. (6) Gabapentin comes in the form of tablets, capsules and liquid form for those who have difficulty swallowing. 

Gabapentin is used off-label for the treatment of abdominal pain in patients suffering from irritable bowel syndrome so it is important to take the dose prescribed by your doctor. (3) The dose can depend on the needs and severity of your condition which can vary from person to person.  Make sure that you take only the prescribed dose because a larger dose can cause severe side effects.

If you decide to stop taking Gabapentin or experience any side effects, consult with your doctor first before stopping it cold turkey. The doctor will taper or wean off the medication by slowly reducing the dose over a week to prevent withdrawal symptoms.

Gabapentin can be taken only with a prescription, so you must consult with your healthcare practitioner first.

Potential side effects of Gabapentin when taken for IBS

Some of the common side effects include- 

  • Dizziness
  • Fatigue
  • Fever
  • Nausea
  • Vomiting
  • Tremor
  • Diarrhoea
  • Weight gain
  • Back pain
  • Constipation (6)

The serious side effects include-

  • Suicidal tendency
  • Depression
  • Anaphylaxis
  • Angioedema
  • Withdrawal seizure (6)

What to do if Gabapentin is not helping your IBS?

 If Gabapentin is not helping your IBS, the healthcare practitioner may prescribe you some other medications that help with the abdominal pain caused due to irritable bowel syndrome (IBS).

Some of the medications include-

  • Antispasmodics- These are also called smooth muscle relaxants. These can help to ease your pain by relaxing the muscles in your abdomen and reducing pain.
  • Tricyclic antidepressants- The doctor may prescribe you amitriptyline or nortriptyline. These medications can reduce pain by changing the way pain signals are processed by the brain.
  • Selective serotonin reuptake inhibitors- The doctor may prescribe paroxetine or citalopram which help to improve mood and overall well-being and reduce the pain by increasing the serotonin levels in the brain.
  • Peppermint capsules- Sometimes coated peppermint capsules are prescribed to ease abdominal pain. 
  • To treat IBS with diarrhoea, your doctor may recommend loperamide, rifaximin or eluxadoline.
  • To treat IBS with constipation, your doctor may recommend laxatives, lubiprostone, linaclotide or plecanatide. (7)

There is no particular diet or medication that works for IBS, but some general tips should be considered to manage the symptoms effectively-

  • Do not skip meals
  • Do not eat spicy or fatty food
  • Do not eat more than 3 portions of fruits in a day
  • Do not drink more than 3 cups of caffeinated drinks in a day(1)

Conclusion

To sum up, we have discussed the use and efficacy of gabapentin in the treatment of irritable bowel syndrome (IBS). 

Many research studies have found that gabapentin is effective in managing the abdominal pain symptoms observed in IBS. However, IBS should be effectively managed through diet and lifestyle modifications as it can lead to severe complications.

It is important to follow the dose and frequency of the medication as prescribed by the doctor to avoid any side effects caused by Gabapentin.

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References

1.-

nhs.uk [Internet]. 2017 [cited 2023 Sep 18]. Irritable bowel syndrome (IBS). Available from: https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/ 

2.-

Vasant DH, Paine PA, Black CJ, Houghton LA, Everitt HA, Corsetti M, et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut [Internet]. 2021 Jul [cited 2023 Sep 18];70(7):1214–40. Available from: https://gut.bmj.com/lookup/doi/10.1136/gutjnl-2021-32459

3.-

Lacy BE, Weiser K, De Lee R. The treatment of irritable bowel syndrome. Therap Adv Gastroenterol [Internet]. 2009 Jul [cited 2023 Sep 18];2(4):221–38. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002524/

 

4.-

Zhang MM, Liu SB, Chen T, Koga K, Zhang T, Li YQ, et al. Effects of NB001 and gabapentin on irritable bowel syndrome-induced behavioral anxiety and spontaneous pain. Molecular Brain [Internet]. 2014 Jun 16 [cited 2023 Sep 18];7(1):47. Available from: https://doi.org/10.1186/1756-6606-7-47

 

5.-

Chen L, Ilham SJ, Feng B. Pharmacological approach for managing pain in irritable bowel syndrome: a review article. Anesth Pain Med [Internet]. 2017 Jan 25 [cited 2023 Sep 18];7(2):e42747. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556397/

 

6.-

Yasaei R, Katta S, Saadabadi A. Gabapentin. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Sep 18]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK493228/ 

7.-

National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. [cited 2023 Sep 18]. Treatment for irritable bowel syndrome – niddk. Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/treatment