What alternative treatment options are available for managing chronic irritable bowel syndrome (IBS) characterized by nocturnal worsening, severe flatulence, and abdominal borborygmi that have not responded to probiotics, levosulpiride, and fiber supplements?
Since probiotics, fiber, and levosulpiride haven't brought relief, there are other gentle paths we can explore. For the severe gas and rumbling, a temporary low-FODMAP diet or a course of a non-absorbable antibiotic like rifaximin can help, as these symptoms sometimes suggest small intestinal bacterial overgrowth. Additionally, a low-dose tricyclic antidepressant, such as amitriptyline, can calm the gut-brain connection, ease pain, and improve your sleep. Antispasmodics like dicyclomine may also reduce cramping. Please discuss these options with your doctor.