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• Introduction: The purpose of this study analysis is to compare tricyclic antidepressant (TCA) to diet modification and visceral manipulation in the treatment of irritable bowel syndrome (IBS).

• Research Methods: Three databases were searched including PubMed, Google Scholar and ClinicalKey, within a time frame of 20 years. Studies chosen for review were peer reviewed and focused on randomized control trials.

• Discussion:

– Diet modification appears to be the most beneficial with the least amount of side effects when compared to TCA use, however, more research needs to be done to evaluate how patients react to reintroduction of foods with elimination diets.

– Visceral manipulation appears to help with refractory symptoms, but more studies need to be conducted due to the newer usage of this option as a treatment for IBS.

– Tricyclic antidepressants are currently one of the most effective medications for overall symptom improvement, however, more side effects are seen with this treatment option due to anticholinergic effects of these medications.

– Due to the multifactorial process of IBS, a combination of treatment options is likely to benefit patients more than a single approach alone, to adequately treat patient symptoms.


Physician Assistant Studies

Degree Name

Master of Physician Assistant Studies (MPAS)

Date of Work


First Advisor

Andvik, Vicki

Publication Date

Spring 2024


irritable bowel syndrome, tricyclic antidepressants, low FODMAP diet, diet modification, visceral manipulation


Medicine and Health Sciences

Treatment of Irritable Bowel Syndrome: Tricyclic Antidepressants vs. Diet Modification and Visceral Manipulation