A recent study published in “Current Medical Research and Opinion” stated that in primary care settings, IBS-D can be appropriately treated in the absence of alarm features. During therapy selection, the risks and advantages of pharmacologic interventions should be weighed. Jennifer Jones et al. undertook this study to summarize the current recommendations for diagnosing IBS-D and offer a brief overview of the available therapeutic choices, emphasizing a novel United States Food and Drug Administration (FDA)-approved agent, eluxadoline.

Using PubMed, the literature on IBS-D was evaluated up to January 2020, with key search terms incorporating ‘eluxadoline’, ‘IBS-D diagnosis’, and ‘IBS-D management’. It was noted that effective treatment of IBS-D requires a personalized management strategy. To adequately guide treatment, the evidence-based therapeutic options endorsed by the American College of Gastroenterology and the American Gastroenterological Association can be utilized. Lifestyle and dietary modifications, including suitable hydration, lowering alcohol and caffeine consumption, and improving soluble fiber consumption may alleviate the symptoms.

Over-the-counter medications like loperamide are commonly suggested and may improve rectal urgency and stool frequency. But, mixed results have been noted for the outcome of abdominal pain. Numerous off-label prescription medicines are valuable to treat IBS-D, including antispasmodics, tricyclic antidepressants, and bile acid sequestrants. For IBS-D, three prescription medications have been granted FDA-approval: eluxadoline, alosetron, and rifaximin.