Diagnosis and treatment of irritable bowel syndrome with predominant constipation in the primary-care setting: focus on linaclotide

Irritable bowel syndrome (IBS) is a complex functional gastrointestinal disorder that is exceedingly common in clinical practice. IBS with predominant constipation (IBS-C) is a subtype of IBS that accounts for more than a third of the IBS diagnosed. Diagnosis of IBS requires a careful personalized a...

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Bibliographic Details
Published in:International journal of general medicine 2017-01, Vol.10, p.385-393
Main Author: Chandar, Apoorva Krishna
Format: Article
Language:English
Subjects:
Abdomen
Care and treatment
Clinical medicine
Clinical trials
Comorbidity
Constipation
Costs
Development and progression
Evaluation
Gastroenterology
Habits
Health maintenance organizations
HMOs
Irritable Bowel Syndrome
Irritable Bowel Syndrome with Predominant Constipation
Linaclotide
Medical care quality
Medical research
Multiculturalism & pluralism
Pain
Patients
Primary Care
Review
Rome IV
Systematic Review
Womens health
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Description
Summary:Irritable bowel syndrome (IBS) is a complex functional gastrointestinal disorder that is exceedingly common in clinical practice. IBS with predominant constipation (IBS-C) is a subtype of IBS that accounts for more than a third of the IBS diagnosed. Diagnosis of IBS requires a careful personalized approach, a comprehensive clinical history, limited but relevant investigations, and continued follow-up. Major IBS societies and guidelines recommend offering a positive diagnosis of IBS based on presenting symptomatology. Abdominal pain that may or may not be relieved by defecation is the cardinal symptom of IBS; distension and bloating are other common symptoms. Careful attention should be paid to alarm symptoms before a diagnosis of IBS is made. Pharmacotherapy with linaclotide is recommended for moderate-severe IBS-C, based on high-quality evidence from randomized controlled trials. Diarrhea is the major side effect of linaclotide, and limited cost-effectiveness data currently exist.
ISSN:1178-7074
1178-7074
DOI:10.2147/IJGM.S126581