Abstract

Diarrhea-Predominant Irritable Bowel Syndrome: Medical Management Update

J Can Assoc Gastroenterol. 2019 Dec 3;3(6):e37-e48. doi: 10.1093/jcag/gwz034.eCollection 2020 Dec.

Christopher N Andrews 1, Marc Bradette 2

 
     

Author information

  • 1Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada.
  • 2Division of Gastroenterology, Centre Hospitalier Universitaire de Québec (CHU), Laval University, Québec, Québec, Canada.

Abstract

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder, which impacts the quality of life, work productivity and social activities of patients. Diarrhea-predominant IBS (IBS-D) is one of several subtypes, and accounts for approximately one third of all cases. Currently available treatments are typically unable to alleviate the cardinal symptoms of IBS-D, including abdominal pain and diarrhea, and a clinical unmet need remains for an effective treatment which simultaneously relieves multiple symptoms. Patients may benefit from a multipronged, individualized approach, including dietary modifications, and psychological and pharmacological therapies. The aim of this review is to provide an update on the available and upcoming treatment options for IBS-D in Canada, with reference to the recently updated Canadian IBS consensus guidelines. Initial treatment approaches include lifestyle modifications, dietary modifications, and non-prescription therapies such as peppermint oil. While some medications such as tricyclic antidepressants are also used to treat IBS-D symptoms, eluxadoline and rifaximin are the only two pharmacological therapies approved for the treatment of IBS-D in Canada. Key clinical trial data for the currently available pharmacological options are presented to provide an overview of the efficacy and safety of these agents.

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