Munjal A¹, Dedania B², Cash B³. Curr Gastroenterol Rep. 2019 Apr 25;21(6):25. doi: 10.1007/s11894-019-0692-7.

Author information

1 Department of Internal Medicine, University of Texas Health Science Center at Houston/McGovern Medical School, 6431 Fannin Street, Houston, TX, 77030, USA.

2 Division of Gastroenterology, University of Texas Health Science Center at Houston/McGovern Medical School, 6431 Fannin Street, MSB 4.234, Houston, TX, 77030, USA.

3 Division of Gastroenterology, University of Texas Health Science Center at Houston/McGovern Medical School, 6431 Fannin Street, MSB 4.234, Houston, TX, 77030, USA. brooks.d.cash@uth.tmc.edu.

Abstract

PURPOSE OF REVIEW: Irritable bowel syndrome (IBS) is a functional GI disorder that affects a large percentage of the population and presents a significant socio-economic burden on the society. In this article, we reviewed the evidence supporting various pharmacological treatment options for IBS.

RECENT FINDINGS: Rifaximin, eluxadoline, and alosetron have demonstrated that they reduce symptom severity improving quality of life in patients with IBS-diarrhea. Ramosetron is a promising agent in development. Peppermint oil has also demonstrated a positive impact on some symptoms of IBS. For IBS with constipation, traditional laxatives have failed to demonstrate significant benefit. However, lubiprostone, linaclotide, and plecanatide have demonstrated improvement of IBS with constipation in large, placebo-controlled trials. Tenapanor, a sodium/hydrogen exchanger 3 inhibitor, appears to be a promising treatment option in the pipeline. There are multiple pharmacologic agents with a variety of mechanisms that have demonstrated efficacy in IBS with diarrhea and constipation. There are no established pharmacologic agents for IBS with a mixed bowel pattern. There is a promising pipeline for additional novel therapies for IBS.