title: Hot Topics in Primary Care: Individualizing Pharmacologic Management of Irritable Bowel Syndrome.
abstract: Irritable bowel syndrome is a common gastrointestinal disorder with constipation, diarrhea, and mixed subtypes. The diagnosis is generally based on a detailed history utilizing the Rome III criteria. Alarm signals necessitate more extensive diagnostic evaluation. Nonpharmacologic options and over-the-counter remedies (e.g., loperamide) might not be supported by strong evidence, but are often chosen as initial treatment for their safety and tolerability. Psychological interventions may be beneficial. Newer pharmacologic agents such as alosetron, eluxadoline, linaclotide, lubiprostone, and rifaximin are supported by higher quality evidence than older agents such as antispasmodics and laxatives. Patients with IBS commonly report that clinicians offer insufficient empathy and validation of their symptoms. Physicians therefore should strive to improve communication methods that specifically provide such reassurance. Individualizing treatment based on patient values and preferences is essential.
authors: Clinical Assistant Professor Emeritus, Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
authors: Louis
authors: L
authors: Kuritzky
mesh_terms: D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents