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