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Diagnosis and treatment of diarrhea-predominant irritable bowel syndrome

Authors Lacy B

Received 4 August 2015

Accepted for publication 5 November 2015

Published 11 February 2016 Volume 2016:9 Pages 7—17

DOI https://doi.org/10.2147/IJGM.S93698

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Jaya Mallidi

Peer reviewer comments 5

Editor who approved publication: Dr Scott Fraser


Brian E Lacy

Division of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

Abstract: Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders worldwide. The economic impact of IBS on the health care system is substantial, as is the personal impact on patients. Patients with diarrhea-predominant IBS (IBS-D) comprise a substantial proportion of the overall IBS population. Primary care providers are often the first point of contact for patients with IBS-D and can accurately diagnose IBS after a careful history and examination without extensive diagnostic tests. Several pharmacologic treatments (eg, loperamide, alosetron, and antidepressants) and non-pharmacologic treatments (eg, dietary modification and probiotics) are available for IBS-D, but restrictions on use (eg, alosetron) or the lack of controlled trial data showing reductions in both global and individual IBS-D symptoms (eg, bloating, pain and stool frequency) emphasize the need for alternative treatment options. Two newer medications (eluxadoline and rifaximin) were approved in May 2015 for the treatment of IBS-D, and represent new treatment options for this common gastrointestinal condition.

Keywords: abdominal pain, antibiotic, bloating, diarrhea, irritable bowel syndrome

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