A number of drugs may be prescribed for IBS treatment:

• Linaclotide is specifically indicated for moderate to severe IBS with constipation
• Amitriptyline – a tricyclic antidepressant – at low dose (usually 10-30mg at night) is
  an unlicensed indication and can be used for abdominal pain or discomfort as a second-line option in patients who have not responded to antispasmodics, anti-motility drugs or laxatives
• Selective serotonin reuptake inhibitor (SSRIs) such as citalopram or fluoxetine may be considered in those who do not respond to a tricyclic antidepressant. Again, this is
  an unlicensed use. 

Reflective exercises

• What three specific questions would you ask a patient about symptoms in relation to IBS? 
• What are your top three recommendations for lifestyle changes that may help with IBS symptoms?