###Human: I am diagnosed with IBS with alternative bowel habits and bloating. Please help. ###Assistant: Hello,  Welcome to icliniq.com. I understand that you know very well about your disorder as of now. The basic problem with the IBS-D (irritable bowel syndrome with diarrhea) is the spastic contraction of bowel and increased secretion of various gut hormones leading to abdominal pain and diarrhea. Since you have tried many medications so far, I see there is still a role of low dose antidepressant medication which help normalize the gut hormones in balance. But unfortunately, these drugs have some side effects, not necessarily mental wise but some physical adverse effects such as dry mouth, dry eyes, and can sometimes lead to constipation and also could cause increased sleep. But since we recommend the patient to start with a low dose and then gradually step up if tolerated well. You can take tablet Amitryptline 5 to 10 mg once daily at night time. And your mind will take sometime before actual improvement. Like it can give you relief in two to four weeks time. Try it for four weeks and come back to me to discuss if we need to increase the dose or add some add on medication. Uncontrollable IBS D. Follow up after 4 weeks.