A large new study examining two decades of health records has found that some medications commonly used to treat irritable bowel syndrome are associated with a higher risk of early death, though researchers and outside experts stressed the individual risk remains small.
Scientists at Cedars-Sinai Health Sciences University in Los Angeles conducted what they describe as the largest real-world study of its kind, drawing on data from nearly 670,000 adults in the United States. The study looked at FDA-approved IBS medications as well as antidepressants, antispasmodics, and opioid-based antidiarrheal drugs including loperamide and diphenoxylate.
Long-term use of antidepressants to treat IBS symptoms was associated with a 35% higher risk of death. The researchers acknowledged that the study does not establish direct causation. The observed associations, they noted, may reflect higher rates of adverse outcomes such as cardiovascular events, falls, and stroke rather than the drugs causing death directly.
"Many patients are diagnosed with IBS at a young age and may remain on medications for years," said Ali Rezaie, MD, the medical director of the GI Motility Program at Cedars-Sinai and senior author of the study. "However, most clinical trials of these medications last less than a year, so we know very little about their long-term safety. This study begins to address that gap."
Rezaie was direct about what patients should take from the findings. "IBS patients should not panic, but they do need to understand and weigh the small but meaningful risks when considering long-term treatments," he said in a statement.
Rudolph Bedford, MD, a gastroenterologist at Providence Saint John's Health Center in Santa Monica who was not involved in the research, echoed that caution. He told Healthline that the symptoms of IBS can be painful and debilitating, and that for many patients the medications do more good than harm. "The benefits definitely outweigh the risks for many patients," he said.
IBS affects a significant portion of the population, and many patients cycle through multiple treatments over years or decades before finding relief. The condition is not life-threatening on its own, but its symptoms, including chronic abdominal pain, bloating, and disrupted bowel habits, can severely limit daily functioning. Researchers suggested that patients with IBS who are on long-term medication regimens discuss the findings with their doctors, particularly if they have additional risk factors for cardiovascular disease.
The study also pointed to non-pharmacological options. Researchers noted that dietary changes aimed at minimizing trigger foods, daily exercise, and stress management can help control IBS symptoms and may reduce reliance on medications over time. Those strategies carry none of the long-term safety concerns raised by the new data, though they are not effective for all patients and are rarely sufficient on their own for those with moderate to severe IBS.
