Last updated April 19, 2023

Pharmacological Management of Irritable Bowel Syndrome With Constipation

Summary of Recommendations

In patients with IBS-C, the AGA suggests using tenapanor ( Moderate , Conditional (weak) )
612
In patients with IBS-C, the AGA suggests using plecanatide ( Moderate , Conditional (weak) )
612
In patients with IBS-C, the AGA recommends using linaclotide ( High , Strong )
612
In patients with IBS-C, the AGA suggests using tegaserod ( Moderate , Conditional (weak) )
Implementation remark: Tegaserod was reapproved for women under the age of 65 years without a history of cardiovascular ischemic events (such as myocardial infarction, stroke, TIA, or angina)
612
In patients with IBS-C, the AGA suggests using lubiprostone ( Moderate , Conditional (weak) )
612
In patients with IBS-C, the AGA suggests using PEG laxatives ( Low , Conditional (weak) )
612
In patients with IBS, the AGA suggests using TCAs ( Low , Conditional (weak) )
612
In patients with IBS, the AGA suggests against using SSRIs ( Low , Conditional (weak) )
612
In patients with IBS, the AGA suggests using antispasmodics ( Low , Conditional (weak) )
612

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Recommendation Grading

Disclaimer

Overview

Title

Pharmacological Management of Irritable Bowel Syndrome With Constipation

Authoring Organization

Publication Month/Year

June 21, 2022

Supplemental Implementation Tools

Decision Aid, Algorithm, Patient Information, Webinar, CME

Document Type

Guideline

Country of Publication

US

Document Objectives

Irritable bowel syndrome (IBS) is a common disorder of gut–brain interaction associated with significant disease burden. This American Gastroenterological Association guideline is intended to support practitioners in decisions about the use of medications for the pharmacological management of IBS-C and is an update of a prior technical review and guideline.

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, IBS-C, irritable bowel syndrome with constipation

Source Citation

Chang L, Sultan S, Lembo A, et al. AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Constipation. Gastroenterology. 2022;163:118–136. 

Supplemental Methodology Resources

Data Supplement