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
...eatmen...
...able 1. US Food and Drug Administration (FDA) -app...
...ents With IBS-D
...s with IBS-D, the AGA suggests using eluxa...
...patients with IBS-D, the AGA suggests using rifa...
...ts with IBS-D with initial response to rifaxi...
...ents with IBS-D, the AGA suggests using alos...
...ts with IBS-D, the AGA suggests using loperam...
...tients With...
...s with IBS, the AGA suggests using tricyclic ant...
...IBS, AGA suggests against using selectiv...
...patients with IBS, the AGA suggests...