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Guideline

Pharmacological management of irritable bowel syndrome with constipation (IBS-C)

Nine clinical recommendations to guide the use of FDA-approved and over-the-counter medications for irritable bowel syndrome with predominant constipation (IBS-C).

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Recommendations

1. In patients with IBS-C, AGA suggests using tenapanor.

2. In patients with IBS-C, AGA suggests using plecanatide.

3. In patients with IBS-C, AGA recommends using linaclotide.

4. In patients with IBS-C, AGA suggests using tegaserod. Implementation remark: Tegaserod was reapproved for women under the age of 65 years without a history of cardiovascular ischemic events (such as myocardial infarction, stroke, TIA, or angina).

5. In patients with IBS-C, AGA suggests using lubiprostone.

6. In patients with IBS-C, AGA suggests using polyethylene glycol (PEG) laxatives.

7. In patients with IBS, AGA suggests using tricyclic antidepressant (TCAs).

8. In patients with IBS, AGA suggests against using selective serotonin reuptake inhibitors (SSRIs).

9. In patients with IBS, AGA suggests using antispasmodics.

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