Analgesic drugs that are used in treating irritable bowel syndrome (IBS) can be classified as non-narcotic or narcotic:
- Non-narcotic: Non-narcotic analgesic drugs (aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs, also known as NSAIDS) are usually of little benefit in treating the abdominal pain of irritable bowel syndrome (IBS). Tramadol (brand name Ultram), is a non-narcotic analgesic drug that binds to opiate receptors in the brain and alters serotonin and norepinephrine reuptake, which inhibits the transmission of pain signals to the brain through ascending pathways from the body and gut. It is best to begin with a very low dosage and gradually increase it over several days to reduce the likelihood of unacceptable side effects (mainly nausea).
- Narcotic: Narcotic analgesic drugs are usually not prescribed for continuous treatment because of possible development of physical dependency or addiction and unwanted side effects, such as drowsiness and interference with clear thinking. Furthermore, continuous narcotic use can actually increase pain sensitivity and also alter gut motility, leading to severe constipation. This is called the "narcotic bowel syndrome". Keeping these cautions in mind, narcotic analgesic drugs are occasionally used to relieve intermittent attacks of more severe pain.