Review of the Patient Burden and Therapeutic Landscape of Irritable Bowel Syndrome with Constipation in the United States
Irritable bowel syndrome (IBS) is a prevalent disorder of the gut-brain axis, with IBS subtype with constipation (IBS-C) accounting for roughly one-third of all cases. IBS-C is associated with significant patient burden and a reduced quality of life. This narrative review aims to provide a comprehensive overview of current and emerging treatment options for IBS-C, focusing on disease management from a US healthcare perspective. It emphasizes the critical role of the therapeutic relationship between patients and healthcare providers in facilitating accurate diagnosis and effective treatment.
A positive diagnostic approach for IBS-C is recommended, incorporating clinical history, physical examination, and selective laboratory tests to rule out other conditions. Effective communication between patients and healthcare providers is vital for ensuring timely diagnosis, improving patient outcomes, and reducing both healthcare costs and the overall disease burden.
Initial treatment for IBS-C generally includes lifestyle modifications and nonpharmacologic interventions, such as dietary changes, fiber supplementation, and osmotic laxatives. For patients who do not respond adequately to these approaches, four FDA-approved medications—lubiprostone, linaclotide, plecanatide, and tenapanor may provide symptom relief. These therapies are typically well tolerated and have demonstrated efficacy in reducing both constipation and abdominal pain. For patients with ongoing abdominal discomfort or co-occurring psychological symptoms, brain-gut behavioral therapy or neuromodulatory treatments may offer additional benefits.