What Is the Treatment of Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterised by recurrent abdominal pain and bowel disturbance. When pharmacological management is considered appropriate, structured first-line protocols define the recommended approach.
Treatment Approach
The first-line protocol involves gut-brain neuromodulators as a key pharmacological option; specific agent selection, dosing strategy, and the complete clinical algorithm are detailed in the full regimen.
Clinical Goals
Relief of global IBS symptoms and reduction of abdominal pain.
References
DOI: 10.1053/j.gastro.2022.04.016
- The AGA suggests using TCAs in patients with IBS.
- The type of TCA studied included amitriptyline (n = 3), desipramine (n = 2), trimipramine (n = 1), imipramine (n = 1), and doxepin (n = 1).
- The dose of the TCA varied from 10 mg to up to 150 mg and most studies used >50 mg per day.
- The AGA suggests using antispasmodics in patients with IBS.
- Of the antispasmodics studied, only hyoscine, dicyclomine, and peppermint oil are available in the United States.
- Compared with placebo, TCAs were associated with global symptom relief (RR, 0.67; 95% CI, 0.54–0.82) and abdominal pain relief (RR, 0.76–0.94).
- Likewise, compared with placebo, antispasmodics showed improvement in abdominal pain (RR, 0.74; 95% CI, 0.59–0.93).
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