IRRITABLE BOWEL DISEASE/SYNDROME

IBS-D is a subtype of irritable bowel syndrome (IBS) characterized by chronic or recurrent abdominal pain associated with altered bowel habits, with diarrhea being the predominant symptom. This condition affects approximately 4% of the global population and can have a significant impact on patients' quality of life, work productivity, and healthcare costs. Pharmacological treatment options for IBS-D are challenging due to the heterogeneous patient population, patients' expectations, and the multifactorial and incompletely understood underlying pathophysiology. Currently, pharmacological treatments focus on targeting individual symptoms such as abdominal pain, altered bowel habits, and bloating. Some of the current pharmacological treatment options for IBS-D include antispasmodics, tricyclic antidepressants, selective serotonin reuptake inhibitors, and probiotics. Newer drugs such as linaclotide and eluxadoline have shown promising results in clinical trials. To guide healthcare professionals in treating individual patients with IBS-D, a pharmacological treatment algorithm is proposed in the review. The algorithm takes into account the severity of symptoms, patient expectations, and potential adverse effects of the medications. In conclusion, IBS-D remains a challenging condition to treat due to its multifactorial nature and the lack of effective medications. However, current and newer pharmacological treatments can help target individual symptoms and improve patients' quality of life. The proposed pharmacological treatment algorithm can guide healthcare professionals in selecting the most appropriate treatment for individual patients.