Pharmacological Management of Irritable Bowel Syndrome With Diarrhea
Summary of Recommendations
Eluxadoline
Rifaximin
Alosetron
Loperamide
TCAs
SSRIs
Antispasmodics
Video
Recommendation Grading
Overview
Title
Pharmacological Management of Irritable Bowel Syndrome With Diarrhea
Authoring Organization
American Gastroenterological Association
Publication Month/Year
June 20, 2022
Last Updated Month/Year
October 3, 2024
Supplemental Implementation Tools
Document Type
Guideline
Country of Publication
US
Document Objectives
The purpose of this guideline is to provide evidence-based recommendations for the pharmacological management of individuals with IBS-D based on a systematic and comprehensive synthesis of the literature. In addition, we included the recommendations for the following 3 classes of pharmacotherapeutic agents for IBS: tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and antispasmodics, not specific to one bowel subtype, which were included in the prior TR and guidelines.
Target Patient Population
Patients with irritable bowel syndrome with diarrhea
Target Provider Population
Primary care and gastroenterology health care professionals, patients, and policy makers.
PICO Questions
Should Eluxadoline Be Used in Patients With Irritable Bowel Syndrome With Diarrhea?
Should Rifaximin Be Used for Patients With Irritable Bowel Syndrome With Diarrhea for Initial Treatment and Retreatment?
Should Alosetron Be Used in Patients With Irritable Bowel Syndrome With Diarrhea?
Should Loperamide Be Used in Patients With Irritable Bowel Syndrome With Diarrhea?
Should Tricyclic Antidepressants Be Used in Patients With Irritable Bowel Syndrome?
Should Selective Serotonin Reuptake Inhibitors Be Used in Patients With Irritable Bowel Syndrome?
Should Antispasmodics Be Used in Patients With Irritable Bowel Syndrome?
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Ambulatory
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Treatment, Management
Diseases/Conditions (MeSH)
D043183 - Irritable Bowel Syndrome
Keywords
irritable bowel syndrome (IBS), IBS-D, IBS, irritable bowel syndrome with diarrhea
Source Citation
Lembo A, Sultan S, Chang L, et al. AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Diarrhea. Gastroenterology. 2022;163:137-151.