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Updated: Mar 17, 2026
Perturbations of Circulating miRNAs in Irritable Bowel Syndrome Detected Using a Multiplexed High-throughput Gene Expression Platform
Published on: November 30, 2016
Diarrhea-predominant irritable bowel syndrome: Diagnosis, etiology, and new treatment considerations
Brian E Lacy1, Julie C Moreau1
1Division of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Purpose:
To provide an overview of irritable bowel syndrome (IBS), specifically the efficacy and tolerability of treatment options for diarrhea-predominant IBS (IBS-D).
Data Sources:
Research articles available via PubMed were reviewed.
Conclusions:
IBS is a chronic multifactorial disorder that has a negative impact on patient-related quality of life. Genetic factors, psychosociologic factors, alterations in the gut microbiota, and changes in immune, motor, and sensory responses to various stimuli all may be involved in the development of IBS. While pharmacologic therapies for IBS-D have historically been limited (e.g., alosetron), newer therapies (eluxadoline and rifaximin), both approved in the United States in 2015, may be considered for appropriate patients for the management of IBS-D.
Implications For Practice:
Nurse practitioners play an important role in the diagnosis, care, and management of patients with IBS-D. The goals of therapy should be to reach a correct diagnosis before initiating therapy, provide reassurance to the patient, educate the patient on potential treatment options, improve IBS-D symptoms, minimize risk of harm with treatment, and maximize patient-related quality of life. The authors present a treatment algorithm to guide nurse practitioners on the management of patients with IBS-D.
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