Zelnorm

My daughter is a freshman in college and has been diagnosised with IBS. Several lesser treatments of Miralax and other similar things have been tried. Zelnorm is the most recent. However the instructions are to take it one hour before meals. Her schedule and lifestyle make this virtually impossible. Is there any other way to take this medication and still achieve affectiveness? Also, if this doesn't work, which seems to be a distinct possibility, what other treatments exist? How do we actually know that she has this condition?

[Kevin Pho, MD]

IBS is typically a "diagnosis of exclusion" - meaning it is considered if all the other causes have been ruled out.  There is no specific test to diagnose this disorder.

Typically Zelnorm is administered 30-60 minutes before meals for effectiveness.  I am not aware of an alternative dosing schedule.

As for other treatments, antidepressant therapy (tricyclics in particular - to be used cautiously in those with constipation) as well as antispasmodic therapy have been used with varying degrees of success.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.