AGA Family of Websites: Gastro.org
Guideline

Pharmacological management of irritable bowel syndrome with diarrhea (IBS-D)

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

Guideline Tool kits

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Recommendations

1. In patients with IBS-D, AGA suggests using eluxadoline. Implementation remark: Eluxadoline is contraindicated in patients without a gallbladder or those who drink more than 3 alcoholic beverages per day.

2a. In patients with IBS-D, AGA suggests using rifaximin.

2b. In patients with IBS-D with initial response to rifaximin who develop recurrent symptoms, AGA suggests retreatment with rifaximin.

3. In patients with IBS-D, AGA suggests using alosetron.

4. In patients with IBS-D, AGA suggests using loperamide.

5. In patients with IBS, AGA suggests using tricyclic antidepressants (TCAs).

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

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

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