From the Guidelines
Treatment for Irritable Bowel Syndrome (IBS) should commence with dietary therapies, including soluble fibre, such as ispaghula, and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), as these have been shown to be effective in managing global symptoms and abdominal pain in IBS 1. The treatment approach should be individualized, taking into account the patient's predominant symptoms and any potential trigger foods. Some key considerations include:
- Regular exercise, which has been shown to be beneficial for patients with IBS, particularly for those with constipation-predominant symptoms 1
- Stress management techniques, such as cognitive behavioral therapy, gut-directed hypnotherapy, and mindfulness-based stress reduction, which can help alleviate symptoms and improve quality of life 1
- Medications, such as loperamide for diarrhea, antispasmodics for abdominal pain, and neuromodulators like tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) for more severe cases 1
- Probiotics, which may help restore gut flora balance, although the evidence is still limited 1 It is essential to note that the treatment of IBS should be tailored to the individual patient's needs, and a multidisciplinary approach, including medical, dietary, and psychological therapies, may be necessary to achieve optimal outcomes 1.
From the FDA Drug Label
1 INDICATIONS AND USAGE VIBERZI is indicated in adults for the treatment of irritable bowel syndrome with diarrhea (IBS-D).
- 3 Irritable Bowel Syndrome with Constipation Lubiprostone is indicated for the treatment of irritable bowel syndrome with constipation (IBS-C) in women at least 18 years old.
Irritable Bowel Syndrome (IBS) Treatment:
- Eluxadoline (PO) is indicated for the treatment of IBS-D in adults 2.
- Lubiprostone (PO) is indicated for the treatment of IBS-C in women at least 18 years old 3. Key points:
- Eluxadoline is used for IBS-D.
- Lubiprostone is used for IBS-C in women.
From the Research
Treatment Options for IBS
- Nonpharmacological interventions, such as dietary and lifestyle modification, are generally used as first-line therapy for IBS treatment 4
- Probiotics have demonstrated efficacy and safety in patients with IBS, but studies are inconsistent in strains examined, dosing, and treatment duration 4
- Psychological therapies, including cognitive behavioral therapy and hypnotherapy, may also improve IBS symptoms 4
Pharmacological Interventions
- US Food and Drug Administration-approved agents for IBS-D include eluxadoline, rifaximin, and alosetron 4
- Other pharmacological interventions for IBS-D include loperamide, smooth muscle antispasmodics, bile acid sequestrants, and antidepressants 4, 5, 6
- Rifaximin has been shown to improve abdominal pain and stool consistency in patients with IBS-D, and has a favorable safety profile 4, 5, 6
Personalized Approach to Treatment
- A personalized approach to IBS treatment is required, taking into account the individual patient's symptoms, quality of life, and preferences 5, 7
- A multidisciplinary approach, including medicinal care, complementary therapies, and lifestyle modifications, may be beneficial in improving symptoms and quality of life 8
Emerging Therapies
- Emerging therapies, such as fecal microbiota transplantation and the use of probiotics, prebiotics, and synbiotics, may offer potential benefits in IBS treatment 5
- Novel drugs are currently in development, targeting the pathophysiology of IBS, including intestinal secretagogues, drugs acting on opioid or 5-HT receptors, and minimally absorbed antibiotics 7