From the FDA Drug Label
The efficacy of LINZESS for the treatment of IBS-C was established in two double-blind, placebo-controlled, randomized, multicenter trials in adult patients VIBERZI is indicated in adults for the treatment of irritable bowel syndrome with diarrhea (IBS-D)
- Treatment options for Irritable Bowel Syndrome (IBS):
- Treatment options for Diverticulosis: No information is provided in the given drug labels regarding the treatment of Diverticulosis.
From the Research
Treatment for irritable bowel syndrome (IBS) and diverticulosis should prioritize symptom management and preventing complications, with a focus on dietary modifications, medications, and stress management techniques. For IBS, the most recent and highest quality study 3 suggests that eluxadoline, a gut-targeting μ and κ opioid receptor agonist and a δ opioid receptor antagonist, can offer relief to patients with IBS-D. The study found that eluxadoline 100 mg by mouth twice/day can improve symptoms in patients with IBS-D, with a composite response rate of 10.3% more patients compared to placebo (p<0.001) 3. Other treatment options for IBS include:
- Dietary modifications, such as following a low-FODMAP diet, increasing fiber intake gradually, and identifying personal food triggers
- Medications, such as antispasmodics like dicyclomine (10-20mg three times daily) for pain, loperamide (2-4mg as needed) for diarrhea, polyethylene glycol (17g daily) for constipation, and tricyclic antidepressants like amitriptyline (10-25mg at bedtime) for pain modulation
- Stress management techniques, such as cognitive behavioral therapy and regular exercise For diverticulosis, a high-fiber diet (25-30g daily) is recommended to prevent constipation and formation of new diverticula. During acute diverticulitis episodes, treatment may include antibiotics like ciprofloxacin (500mg twice daily) plus metronidazole (500mg three times daily) for 7-10 days, temporary liquid diet, and pain management. Both conditions benefit from adequate hydration (at least 8 glasses of water daily), regular physical activity, and maintaining a healthy weight. These approaches work by regulating bowel movements, reducing inflammation, and decreasing pressure within the colon that can exacerbate symptoms or lead to complications. It is essential to note that the treatment of IBS and diverticulosis should be individualized, and patients should be encouraged to work with their healthcare provider to develop a personalized treatment plan. Additionally, the most recent study 3 highlights the importance of considering the benefits and risks of pharmacologic interventions during treatment selection, and clinicians should be familiar with emerging therapies for IBS-D, such as eluxadoline, which may provide benefit to some patients.