Irritable Bowel Syndrome With Diarrhea

Publication Date: June 21, 2022

Key Points

Key Points

  • Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction associated with worse health-related quality of life (QOL) than patients with diabetes or end-stage renal disease.
    • Its worldwide prevalence among adults is between 4.1% (Rome IV criteria) and 10.1% (Rome III criteria). In general, IBS is more common in women and younger individuals; however, the prevalence of IBS with diarrhea (IBS-D) in men and women are comparable.
  • IBS with diarrhea (IBS-D) is a subtype of IBS, with an estimated 30%–40% of IBS cases classified as IBS-D.
  • A positive diagnosis of IBS-D can be made on the basis of medical history and physical examination, evaluation of gastrointestinal symptoms (especially alarm signs), limited diagnostic testing, and use of the symptom-based Rome IV criteria.a
    • The presence of alarm features — such as new symptom onset after age 50 years; rectal bleeding not attributable to hemorrhoids or anal fissures; unintentional weight loss; iron deficiency anemia; nocturnal diarrhea; and a family history of colon cancer, inflammatory bowel disease, or celiac disease — requires more patient-specific investigations.
a Kellow JE, Drossman DA, Chang L, et al, eds. Rome IV Diagnostic Algorithms for Common GI Symptoms. 2nd ed. Rome Foundation, 2016.

Treatment

...Treatment...

...US Food and Drug Administration (FDA) -approved...


...P...

...patients with IBS-D, the AGA suggests...

...ith IBS-D, the AGA suggests using rifaxim...

...with IBS-D with initial response to rifaximin...

...with IBS-D, the AGA suggests using...

...ents with IBS-D, the AGA suggests using loperamid...


...Patients...

...ith IBS, the AGA suggests using tricyclic antid...

...patients with IBS, AGA suggests against u...

...ts with IBS, the AGA suggests using antisp...