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Current and Emerging Pharmacotherapeutic Options for Irritable Bowel Syndrome

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Abstract

Treatment of irritable bowel syndrome (IBS) is challenging for both primary care physicians and gastroenterologists because of the heterogeneity of the patient population and the multifactorial pathophysiologies responsible for the symptoms in IBS. This review focuses on the current and emerging pharmacological treatments for IBS. Many of the current medications used to treat this disorder have distinct properties such as efficacy for different symptoms, safety profiles, contraindications, costs, dosing regimens, treatment duration and long-term data. All of these factors, in addition to patient preference and cognitive, food and environmental triggers, must be considered prior to any medication selection. This review will focus on randomized controlled trials with a general uniformity in study design, a rigorous patient selection and appropriate treatment durations. We will also discuss other exciting emerging treatments for IBS such as the µ-opioid receptor (agonists and antagonists), selective κ-opioid receptor agonists, anti-inflammatory drugs, serotonergic agents, bile acid modulators and intestinal bile acid transporters, which may prove promising in treating our patients.

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Acknowledgments

Our sincere thanks to Glen Whelan, Pharm.D., for help with the figures in our manuscript.

Funding and Conflicts Statement

Jose Barboza has no conflicts of interest to report. Baharak Moshiree has received grants and consulting fees/honorarium from Prometheus Laboratory and has no other conflicts of interest to report. Nicholas Talley has received grant/research support from Abbott Pharmaceuticals, Ironwood, Janssen, Prometheus, Rome III Study, Salix liS Study, Takeda, and owns patents for biomarkers of irritable bowel syndrome.

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Authors and Affiliations

  1. University of South Florida College of Pharmacy, 12901 Bruce B. Downs Blvd. MDC30, Tampa, FL, 33612, USA

    Jose L. Barboza

  2. University of Newcastle, Callaghan, NSW, 2308, Australia

    Nicholas J. Talley

  3. Mayo Clinic, Jacksonville, FL, USA

    Nicholas J. Talley

  4. Division of Gastroenterology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA

    Baharak Moshiree

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  1. Jose L. Barboza
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  2. Nicholas J. Talley
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  3. Baharak Moshiree
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Correspondence to Jose L. Barboza.

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Barboza, J.L., Talley, N.J. & Moshiree, B. Current and Emerging Pharmacotherapeutic Options for Irritable Bowel Syndrome. Drugs 74, 1849–1870 (2014). https://doi.org/10.1007/s40265-014-0292-7

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