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...