brand logo

Am Fam Physician. 2023;108(5):527-529

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Key Points for Practice

• Limited evidence suggests that tricyclic antidepressants and antispasmodic medications improve IBS symptoms, including pain.

• For IBS-C, linaclotide appears to be the most effective medication, with a common adverse effect of diarrhea.

• For IBS-D, rifaximin improves discomfort and bloating and has some benefit with repeat administration for recurrent symptoms.

From the AFP Editors

Irritable bowel syndrome (IBS) affects at least one in every 25 adults worldwide and is more common in women and younger adults. IBS is associated with a decreased quality of life, increased psychological comorbidity, high economic costs, and more than double the rate of work absenteeism. The American Gastroenterological Association (AGA) performed systematic reviews to create guidelines on how to manage IBS with pharmacotherapy.

Global Symptoms

People with IBS are more likely to have difficulty concentrating, feel self-conscious, avoid sex, and not feel able to reach their potential. Several medications have been proposed to treat the global symptoms and abdominal pain of IBS overall. These medications should be considered when alarm symptoms are not present.

Already a member/subscriber?  Log In


From $165
  • Immediate, unlimited access to all AFP content
  • More than 130 CME credits/year
  • AAFP app access
  • Print delivery available

Issue Access

  • Immediate, unlimited access to this issue's content
  • CME credits
  • AAFP app access
  • Print delivery available
Purchase Access:  Learn More

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, Assistant Medical Editor.

A collection of Practice Guidelines published in AFP is available at

Continue Reading

More in AFP

More in PubMed

Copyright © 2023 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.