Review of the Patient Burden and Therapeutic Landscape of Irritable Bowel Syndrome with Constipation in the United States.

Irritable bowel syndrome (IBS) is a common disorder of the gut-brain axis. IBS with constipation (IBS-C) accounts for approximately one-third of IBS cases and is associated with substantial burden of illness and decreased quality of life. This narrative review provides an overview of the current and upcoming treatment options and disease management for IBS-C from a US perspective and discusses the importance of the relationship between patient and health care provider in diagnosis and treatment. A positive diagnostic strategy for IBS-C is recommended, based on clinical history, physical examination, and minimal laboratory tests. An effective communication strategy between patients and health care professionals is essential to ensure early diagnosis and reduce both health care costs and overall disease burden. Treatment typically begins with lifestyle interventions and nonpharmacologic options, such as dietary interventions, fiber supplements, and osmotic laxatives. In patients with inadequate response to these therapies, 4 currently available therapies (lubiprostone, linaclotide, plecanatide, and tenapanor) approved by the US Food and Drug Administration may relieve IBS-C symptoms. These agents are generally well tolerated and efficacious in improving IBS-C symptoms, including constipation and abdominal pain. In patients with persistent abdominal pain and/or psychological symptoms, brain-gut behavioral therapy or neuromodulator therapy may be beneficial.

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© 2024 Sendzischew Shane et al.

Déclaration de conflit d'intérêts

Morgan Allyn Sendzischew Shane reports no disclosures. Michael Cline reports speaker bureau and knowledge leader committees with Ardelyx, Inc, and Evoke Pharma. Baharak Moshiree reports grant funding from Atmo, Restalsis, and Medtronic; advisory committees for Salix, Allergan, Alnylam, Ironwood; speakers’ bureau with Salix, Takeda, QOL Medical, Allergan, Bausch Pharmaceuticals; speaking for Salix & Bausch Pharmaceuticals, Allergan Pharmaceuticals, Cairn Diagnostics and AbbVie; speaking and advisory board with Alnylam, Progenity, and Nestle. Johannah Ruddy, David Rosenbaum, and Susan Edelstein are employed by Ardelyx, Inc. The authors report no other conflicts of interest in this work.