@article{16b42f4574844802ba8a499ea7567dbd,
title = "A Narrative Review of Irritable Bowel Syndrome with Diarrhea: A Primer for Primary Care Providers",
abstract = "Irritable bowel syndrome with diarrhea (IBS-D) is a chronic disorder of gut–brain interaction, characterized by recurrent abdominal pain in association with more frequent, loose stools. The pathophysiology of irritable bowel syndrome (IBS) includes disordered gut motility, alterations in gut microbiota, neural-hormonal system abnormalities, immune reactivity, and visceral hypersensitivity. Timely diagnosis of IBS-D can be achieved easily using clinical criteria. Formal IBS diagnosis is important for optimizing treatment and patient outcomes and facilitating patient access to appropriate educational resources. Yet, given the symptom overlap with other gastrointestinal conditions, diagnosis of IBS-D often is perceived to be challenging. Treatment of IBS includes both nonpharmacologic and pharmacologic options. Rifaximin, alosetron, and eluxadoline are effective treatments indicated for IBS-D, but have limited availability internationally. Dietary approaches may also be indicated for certain patients with IBS-D. Psychological interventions may be effective in treating abdominal pain alone and global symptoms in IBS. We describe use of these diverse therapies and provide an overview to facilitate the primary care provider{\textquoteright}s approach to distinguishing IBS-D from other conditions with symptom overlap.",
keywords = "Abdominal pain, Bloating, Diagnosis, Diarrhea, Gastroenterology, Internal medicine, Irritable bowel syndrome, Primary health care, Therapeutics",
author = "Baha Moshiree and Heidelbaugh, {Joel J.} and Sayuk, {Gregory S.}",
note = "Funding Information: Salix Pharmaceuticals provided funding and support for technical editorial and medical writing assistance and funded the journal{\textquoteright}s Rapid Service and Open Access fees. Salix Pharmaceuticals did not actively contribute to the content or have a role in the decision to submit, but did review the final copy. The authors did not receive any compensation for development of this manuscript. Technical editorial and medical writing assistance were provided, under direction of the authors, by Mary Beth Moncrief, PhD, and Sophie Bolick, PhD, Synchrony Medical Communications, LLC, West Chester, PA. Funding for this assistance was provided by Salix Pharmaceuticals, Bridgewater, NJ. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. All authors were involved in planning of the manuscript, collecting resources, interpreting the data, writing, and critically revising the manuscript. All authors read and approved the final manuscript. Baha Moshiree is a consultant for Salix Pharmaceuticals. She is also on advisory boards for Allergan, AbbVie, Alnylam, and Ironwood Pharmaceuticals; and has research support from Salix, AbbVie, and Medtronic. Grant support: Bausch Pharmaceuticals and Phathom. Joel J. Heidelbaugh reports no conflicts of interest. Gregory S. Sayuk reports having served as a consultant for AbbVie, Ironwood, Salix, and Alnylam Pharmaceuticals; and as a speaker for Salix Pharmaceuticals, Synergy, AbbVie, Ironwood, and Alnylam Pharmaceuticals. This review is based on previously conducted studies and does not contain any new data from human or animal studies conducted by any of the authors. Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study. Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
month = sep,
doi = "10.1007/s12325-022-02224-z",
language = "English",
volume = "39",
pages = "4003--4020",
journal = "Advances in Therapy",
issn = "0741-238X",
number = "9",
}