Irritable Bowel Syndrome With Diarrhea

Publication Date: June 20, 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

Treatme...

.... US Food and Drug Administration (FDA) -a...


...ents With IBS-D...

...ith IBS-D, the AGA suggests using...

...IBS-D, the AGA suggests using rifaxim...

...tients with IBS-D with initial response to r...

...with IBS-D, the AGA suggests using alose...

...with IBS-D, the AGA suggests using loperamide. (...


...ents With IBS...

...th IBS, the AGA suggests using tricyclic antidepre...

...n patients with IBS, AGA suggests against using se...

...patients with IBS, the AGA suggests using ant...