Designed and created by Guideline Central in participation with the American Gastroenterological Association
Irritable Bowel Syndrome With Constipation
Objective
Objective
This patient guideline summarizes key takeaways from the American Gastroenterological Association (AGA) guideline for pharmacological management of irritable bowel syndrome with constipation. The purpose of this guideline is to provide new evidence-based recommendations on the medications used for irritable bowel syndrome with constipation.
Overview
Overview
- Irritable bowel syndrome (IBS) is a common disorder that involves the interaction between the gut and the brain.
- IBS with predominant constipation (IBS-C) is a specific type of IBS, accounting for more than one-third of IBS cases.
- A positive diagnosis of IBS-C can be made based on medical history, physical examination, evaluation of gastrointestinal symptoms (including alarm signs), limited diagnostic testing, and the use of symptom-based criteria known as Rome IV criteria.
- Alarm signs are: new symptoms after the age of 50, rectal bleeding unrelated to hemorrhoids or anal fissures, unintentional weight loss, iron deficiency anemia, nocturnal (night) diarrhea, and a family history of colon cancer, inflammatory bowel disease, or celiac disease require further investigation tailored to the patient's specific needs.
- If you have IBS-C, your care provider may consider prescribing certain medications to help manage your symptoms:
Treatment
Treatment
- Tenapanor is recommended for patients with IBS-C.
- Plecanatide is recommended for patients with IBS-C.
- Linaclotide is strongly recommended for patients with IBS-C.
- Tegaserod is recommended for patients with IBS-C.
- Lubiprostone is recommended for patients with IBS-C.
- PEG laxatives are recommended for patients with IBS-C.
- Tricyclic antidepressants are recommended for patinets with IBS of any type.
- Selective serotonin reuptake inhibitors are not recommended for use in patinets with IBS of any type.
- Antispasmodics are recommended for patients with IBS of any type.
- It's important to discuss these treatment options with your healthcare provider to determine the best approach for your individual situation. Your providers can provide guidance and tailor the treatment plan to meet your needs.
Summary of Medication Recommendations for IBS-C
- Medications that are recommended for irritable bowel syndrome with constipation:
- tenapanor
- plecanatide
- linaclotide
- tegaserod
- PEG laxatives
- Medications that are recommended for all types of irritable bowel syndrome
- tricyclic antidepressants
- antispasmodics
- Medications that are NOT recommended for irritable bowel syndrome of any type:
- selective serotonin reuptake inhibitors
Abbreviations
- AGA: American Gastroenterological Association
- IBS: Irritable Bowel Syndrome
- IBS-C: Irritable Bowel Syndrome With Constipation
- PEG: Polyethylene Glycol
- TCAs: Tricyclic Antidepressants
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.
Disclaimer
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.