Some medications commonly prescribed for irritable bowel syndrome (IBS), including certain antidepressants and opioid-based antidiarrheal drugs, may be linked to a higher risk of death, according to Cedars-Sinai Health Sciences University investigators in an April 8 study.
The findings are important because many patients with IBS start treatment at a young age and may use these medications for years. However, most clinical trials only track outcomes for less than a year, leaving questions about long-term safety unanswered.
Researchers analyzed nearly two decades of electronic health records from over 650,000 U.S. adults with IBS. They found that long-term use of antidepressants was associated with a 35% higher risk of death. Use of loperamide and diphenoxylate—opioid-based antidiarrheals—was linked to roughly double the risk. The study does not prove these drugs directly cause death but notes more frequent adverse outcomes such as cardiovascular events, falls, and stroke among those taking them.
Ali Rezaie, MD, medical director of the GI Motility Program at Cedars-Sinai and senior author on the study said: “Many patients are diagnosed with IBS at a young age and may remain on medications for years. 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.”
While antidepressants are not approved by the Food and Drug Administration specifically for IBS treatment in the United States, they are often used to help manage symptoms such as pain. The research also found that other recommended treatments—including FDA-approved medicines and antispasmodics—were not associated with increased mortality.
Rezaie said: “IBS patients should not panic, but they do need to understand and weigh the small but meaningful risks when considering long-term treatments.” He advised patients to consult their healthcare providers about managing symptoms safely.
Rezaie also called for more research into which patients might face greater risks from these therapies and suggested future guidelines should better address medication safety over time. He concluded: “Treatment for IBS patients should focus on identifying the underlying causes and using the safest evidence-based options available rather than relying on a single class of medications for long-term management.”
Cedars-Sinai Medical Center is located in Los Angeles, California; it was founded in 1902 under its current president Thomas M. Priselac. The hospital admitted more than 50,000 patients during calendar year 2022 according to its annual report.
