Treatment of Irritable Bowel Syndrome with Diarrhea (IBS-D)
IBS-D is a distinct subtype of irritable bowel syndrome defined by diarrhea as the predominant bowel pattern. It represents a substantial proportion of all IBS presentations and calls for a targeted pharmacological strategy.
Clinical Scenario
IBS with diarrhea (IBS-D) is one of the main bowel habit subtypes of IBS, with an estimated 30%–40% of all IBS cases classified as IBS-D. Identifying this subtype is the starting point for selecting an appropriate evidence-based treatment approach.
Treatment Approach
Current evidence supports pharmacological treatment over no drug treatment in eligible patients with IBS-D. Multiple specific agents are recommended, each with distinct patient eligibility criteria that determine which option is appropriate for a given individual.
Full agent selection, eligibility conditions, and clinical criteria are in the complete protocol ↓
Treatment Goals
Symptom relief is defined as both a 30% reduction in average daily worst abdominal pain and a 50% reduction in the number of days per week with at least one loose stool (Bristol Stool Form Scale type 6 or 7), compared with baseline.
References
DOI: 10.1053/j.gastro.2022.04.016IBS with diarrhea (IBS-D) is one of the main bowel habit subtypes of IBS, with an estimated 30%–40% of IBS cases classified as IBS-D.
The AGA suggests using eluxadoline in patients with IBS-D. The AGA suggests using rifaximin in patients with IBS-D. The AGA suggests using alosetron in patients with IBS-D. The AGA suggests using loperamide in patients with IBS-D.
This was defined as a participant who reports both a 30% reduction in average daily worst abdominal pain scores and a 50% reduction in number of days per week with at least 1 stool that has a consistency of type 6 or 7 according to the Bristol Stool Form Scale (BSFS) compared with baseline.
View source ↗