IBS Treatment: New Research & Guidelines

COVID-19’s Lasting Impact: Rising Rates of Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS), a chronic gastrointestinal disorder, is increasingly linked to prior COVID-19 infection, with new research revealing a significantly elevated risk for those who have battled the virus. Affecting between five and ten percent of the global population, IBS presents a substantial burden on quality of life, characterized by recurring abdominal pain, bloating, and fluctuating bowel habits.

The Growing Connection Between COVID-19 and IBS

Recent studies indicate a concerning trend: individuals who have contracted COVID-19 are more than five times more likely to develop IBS compared to those without a SARS-CoV-2 infection. Alarmingly, these symptoms often persist for years, with over half of affected individuals continuing to experience IBS symptoms one to four years post-infection. This suggests COVID-19 may be a significant, and previously underappreciated, trigger for post-infectious IBS (PI-IBS).

Understanding the Complex Mechanisms of PI-IBS

The development of PI-IBS is a complex interplay of biological factors. Viruses, including SARS-CoV-2, can initiate a prolonged immune response that disrupts the delicate neurological control of the intestines. Simultaneously, infection can alter the composition and diversity of gut bacteria, potentially increasing harmful inflammatory organisms and weakening the intestinal barrier. Crucially, the bidirectional communication between the gut and the brain – known as the gut-brain axis – can also be severely compromised. “All of this can lead to those affected reacting more sensitively to stimuli and developing typical IBS symptoms,” according to experts in the field.

Who is Most at Risk?

While anyone can develop PI-IBS following an infection, certain individuals are more vulnerable. Women are disproportionately affected, as are those with pre-existing psychological stressors like anxiety or depression. Prolonged diarrhea during the initial infection, or requiring hospitalization, also significantly increases the risk. This understanding is particularly relevant for pharmacies, as they often serve as the first point of contact for individuals experiencing abdominal discomfort.

Current Treatment Approaches & the Role of Antispasmodics

Treatment for IBS typically follows a multimodal approach, guided by current S3 guidelines. For cramp-like abdominal pain, antispasmodics, such as butylscopolamine (Buscopan® Dragées), are recommended over peripheral analgesics or opioids. A recent study further supports the efficacy of antispasmodics in relieving IBS-related abdominal cramps and pain, specifically highlighting butylscopolamine’s consistent effectiveness in randomized controlled trials. The medication works directly on the smooth muscles of the gastrointestinal tract, providing relief within 15 minutes.

The Pharmacy’s Crucial Role in Patient Care

Pharmacists are uniquely positioned to assist patients experiencing abdominal complaints. Expert advice can help individuals identify potential connections between their symptoms and prior infections, and recommend appropriate treatment options, such as antispasmodics like Buscopan® Dragées. However, it is essential to emphasize that persistent or worsening symptoms warrant a thorough medical evaluation.

Opella, a global leader in over-the-counter medications, is committed to empowering individuals to take control of their health. With a portfolio of trusted brands including Allegra®, Buscopan®, Dulcolax®, Thomapyrin®, and mucosolvan®, Opella serves over 500 million consumers worldwide. As a certified B Corp, the company prioritizes both people and the planet in its mission to make self-care accessible to all.

Important Information Regarding Buscopan® Dragées:

• Active Ingredient: 10 mg Butylscopolaminiumbromid per dragee.
• Other Ingredients: Sucrose, calcium hydrogen phosphate, corn starch, talc, colloidal silicon dioxide, arabic gum, povidone, tartaric acid, stearic acid, macrogol 6000, carnauba wax, bleached wax, titanium dioxide (E171).
• Indications: Treatment of mild to moderate spasms of the gastrointestinal tract, and spastic abdominal complaints in irritable bowel syndrome.
• Contraindications: Hypersensitivity to butylscopolaminium bromide or any ingredients, mechanical stenoses of the gastrointestinal tract, paralytic or obstructive ileus, megacolon, urinary retention due to subvesical obstruction (e.g., prostate adenoma), angle-closure glaucoma, tachycardia, tachyarrhythmia, myasthenia gravis.
• Side Effects: Skin reactions, hypersensitivity reactions (including anaphylactic shock with drop in blood pressure and flushing), dyspnea, tachycardia, dizziness, accommodation disorders, glaucoma attack, inhibition of salivary secretion, diarrhea, nausea, vomiting, stomach problems, inhibition of sweat secretion, micturition disorders, fatigue.
• Warning: Contains sucrose. Pharmacy required.
• Manufacturer: A. Nattermann & Cie. GmbH, Brüningstraße 50, 65929 Frankfurt am Main. Data as of June 2024.

References:

1. Black CJ, Ford AC. An evidence-based update on the diagnosis and management of irritable bowel syndrome. Expert Review of Gastroenterology & Hepatology, 2025; 19(3): 227–242.
2. Porcari S et al. Prevalence of irritable bowel syndrome and functional dyspepsia after acute gastroenteritis: systematic review and meta-analysis. Gut 2024; 73(9): 1431–1440.
3. Layer P et al. Update S3 guidelines for irritable bowel syndrome: definition, pathophysiology, diagnostics and therapy. Z Gastroenterol 2021; 59(12): 1323–1415.
4. Lacy BE et al. On-demand hyoscine butylbromide for the treatment of self-reported functional cramping abdominal pain. Scand J Gastroenterol 2013; 48 (8): 926–935.