The American Gastroenterological Association (AGA) has issued new guidelines to help clinicians navigate drug options for irritable bowel syndrome (IBS).


Published by senior author Shahnaz Sultan, MD, MHSc, inGastroenterology, the evidence-based guidelines (2014;147[5]:1146-1148) are accompanied by a technical review (1149-1172.e2).

For patients with IBS with constipation, the group strongly recommended linaclotide over no drug treatment, with a conditional recommendation for lubiprostone over no drug treatment. The AGA made conditional recommendations for drugs with only ­moderate- or low-quality evidence.


For patients with IBS with diarrhea, the authors conditionally recommended rifaximin, alosetron, and loperamide. 


Tricyclic antidepressants, selective serotonin reuptake inhibitors, and antispasmodics were suggested for persons with IBS, but only as conditional recommendations due to the low quality of available evidence.