Omeprazole for irritable bowel syndrome – a friend or foe?

Omeprazole for irritable bowel syndrome – does it help? 

Read the article to learn what omeprazole is, how it works, and whether it helps with bowel movements. In the article, we also discuss the use of omeprazole in IBS management.

Moreover, we will explain if there is such a thing as the best medicine for IBS and provide you with information on how you can help your IBS with or without medication.

What is omeprazole?

Omeprazole is an active ingredient that stops the stomach from making acid. This medication belongs to a class of drugs known as proton pump inhibitors (PPIs) (1). 

PPIs become activated upon reaching specific cells within the stomach lining through the bloodstream. In those cells, the acidic environment activates PPIs (2).

The active form of PPIs inhibits the proton pump by binding to the specific enzyme, which is the final step in gastric acid production (2). 

This binding leads to a significant reduction in acid secretion into the stomach (2).

Physicians commonly prescribe omeprazole to reduce excess stomach acid production, alleviating the heartburn and associated symptoms (1). 

Omeprazole is sold under the next brand names:

• Prilosec OTC
• Losec
• Losec MUPS
• Pyrocalm
• Omesec

Is omeprazole useful for IBS symptoms?

Omeprazole reduces stomach acid production, which helps in conditions where acid reflux is an issue.

IBS symptoms do not include acid-related symptoms, so you will not improve your IBS-related symptoms using omeprazole.

Why is omeprazole used for IBS management?

Your doctor may have prescribed you omeprazole, but this is not for your IBS specifically. It will be due to acid reflux.

In some cases, a doctor may prescribe a trial of omeprazole for cases of stomach pain to see if this resolves the issue, which would then help form a diagnosis of acid reflux rather than IBS.

However, studies show that it is common to have both IBS and GERD, but this is thought to be due them both being common conditions rather than any other link (3, 4). 

GERD is a chronic condition where stomach acid consistently flows back into the esophagus. 

Symptoms of GERD are (5):

• Heartburn
• Regurgitation 
• Chest pain
• Cough and hoarse voice

To learn more about IBS and GERD, read our article: Can you have IBS and GERD?

If you suffer from both conditions, easing symptoms of GERB could also help IBS, as first-line therapy includes lifestyle changes like (5, 6):

• Stress control
• Regular movement
• Smaller and regular meals
• Avoidance of alcohol
• Limiting coffee and caffeine intake
• Avoidance of food triggers, like spicy and fatty foods

Your doctor may also prescribe you PPIs like omeprazole to treat GERB, and your IBS can improve by impacting the gut-brain axis, but also due to less stress and better sleep (5).

Does omeprazole help with bowel movements?

No, omeprazole will not help with your bowel movements.

You may even notice worsening diarrhea or constipation, which are both known possible side effects of the medication (1).

Are proton pump inhibitors good for IBS?

As we mentioned above, these medications do not treat symptoms of IBS, but IBS patients may take them if they also have GERD.

Although PPIs can improve GERD and potentially well-being, they can also have unwanted effects.

One potential negative effect of taking a PPI medication is that it may cause small intestinal bacterial overgrowth – SIBO.

PPIs reduce gastric acid production, a defense mechanism that protects us from bacterial overgrowth in the small intestine (7).

If you have IBS, then you will already be at a higher risk of getting SIBO in the first place, so it is always good to discuss potential alternative methods to managing acid symptoms with your doctor.

What is the best medicine for irritable bowel syndrome?

IBS is a condition with different subtypes, and there is not a single medicine that works best for all IBS patients. In other words, the one-size-fits-all approach does not work.

In this section, we will discuss non-pharmacological and pharmacological treatments for IBS.

Non-pharmacological approaches to IBS include (8):

• Balanced and regular meals
• Sufficient fiber intake
• Low FODMAP diet
• Specific probiotics
• Sufficient hydration
• Stress management
• Sleep optimization
• Regular movement
• Mindfulness 
• Gut-directed hypnotherapy
• Cognitive-behavioral therapy
• Peppermint oil

To learn more about the non-pharmacological approach to IBS, read our article: 11 ways to treat IBS naturally.

Doctors can also prescribe many pharmacological medicines to help with your IBS. Some of them are (8):

• Laxatives
• Diarrhea medication
• Antispasmodic medication
• Tricyclic antidepressants 
• Selective serotonin reuptake inhibitors

Summary

Omeprazole is a proton pump inhibitor, which means it reduces the production of stomach acid. The medicine treats excess stomach acid in conditions such as GERD.

Many IBS patients suffer from both conditions, and doctors can prescribe omeprazole to alleviate heartburn and other GERD symptoms. 

Improving GERD may also improve IBS symptoms, but omeprazole is not a medication for IBS, unlike some lifestyle changes, like stress management, which can improve both conditions.

Written by Barbara Lešnik, Student Dietitian, reviewed by Kirsten Jackson, Consultant Dietitian BSc Hons, RD, PG Cert