Irritable bowel syndrome - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Irritable bowel syndrome symptoms include recurrent abdominal pain or discomfort that is associated with a change in stool frequency or form. The pain or discomfort may be relieved by defecation.
It is important to determine whether there are any potential precipitating dietary associations such as caffeine, lactose-containing foods, or fructose-containing foods.
Examination of the abdomen is usually unremarkable. There may be mild and poorly localized tenderness in the right lower quadrant and/or left lower quadrant.
The diagnosis is based on the patient's history; there are no specific diagnostic tests. If the patient has worrying symptoms or findings such as anemia, weight loss, or fever, then these require thorough investigation.
Treatment should be individualized and is dependent on the patient's predominant symptoms.

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology. 2006 Apr;130(5):1480-91.[Abstract][Full Text]
Lacy BE, Pimentel M, Brenner DM, et al. ACG clinical guideline: management of irritable bowel syndrome. Am J Gastroenterol. 2021 Jan 1;116(1):17-44.[Abstract][Full Text]
Smalley W, Falck-Ytter C, Carrasco-Labra A, et al. AGA clinical practice guidelines on the laboratory evaluation of functional diarrhea and diarrhea-predominant irritable bowel syndrome in adults (IBS-D). Gastroenterology. 2019 Sep;157(3):851-4.[Abstract][Full Text]
Chey WD, Hashash JG, Manning L, et al. AGA clinical practice update on the role of diet in irritable bowel syndrome: expert review. Gastroenterology. 2022 May;162(6):1737-45.e5.[Abstract][Full Text]
Dionne J, Ford AC, Yuan Y, et al. A systematic review and meta-analysis evaluating the efficacy of a gluten-free diet and a low FODMAPs diet in treating symptoms of irritable bowel syndrome. Am J Gastroenterol. 2018 Sep;113(9):1290-300.[Abstract]
Chang L, Sultan S, Lembo A, et al. AGA clinical practice guideline on the pharmacological management of irritable bowel syndrome with constipation. Gastroenterology. 2022 Jul;163(1):118-36.[Abstract][Full Text]
Lembo A, Sultan S, Chang L, et al. AGA clinical practice guideline on the pharmacological management of irritable bowel syndrome with diarrhea. Gastroenterology. 2022 Jul;163(1):137-51.[Abstract][Full Text]

Referenced Articles

1. Drossman DA, Camilleri M, Mayes FA. AGA technical review on irritable bowel syndrome. Gastroenterology. 2002 Dec;123(6):2108-31.[Abstract]
2. Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology. 2006 Apr;130(5):1480-91.[Abstract][Full Text]
3. Lacy BE, Mearin F, Chang L, et al. Bowel disorders. Gastroenterology. 2016 May;150(6):1393-407.[Abstract]
4. Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012 Aug 8;143(5):1179-87.e3.[Abstract][Full Text]
5. Talley NJ, Gabriel SE, Harmsen WS, et al. Medical costs in community subjects with irritable bowel syndrome. Gastroenterology. 1995 Dec;109(6):1736-41.[Abstract]
6. Everhart JE, Renault PF. Irritable bowel syndrome in office based practice in the United States. Gastroenterology. 1991 Apr;100(4):998-1005.[Abstract][Full Text]
7. Ford AC, Sperber AD, Corsetti M, et al. Irritable bowel syndrome. Lancet. 2020 Nov 21;396(10263):1675-88.[Abstract]
8. Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014 Feb 4;6:71-80.[Abstract][Full Text]
9. Chey WD, Maneerattaporn M, Saad R. Pharmacologic and complementary and alternative medicine therapies for irritable bowel syndrome. Gut Liver. 2011 Sep;5(3):253-66.[Abstract][Full Text]
10. World Gastroenterology Organisation. Irritable bowel syndrome: a global perspective. Sep 2015 [internet publication].[Full Text]
11. Boyce PM, Koloski NA, Taley NJ. Irritable bowel syndrome according to varying diagnostic criteria: are the new Rome II criteria unnecessarily restrictive for research and practice? Am J Gastroenterol. 2000 Nov;95(11):3176-83. [Erratum in Am J Gastroenterol. 2001 Apr;96(4):1319.][Abstract]
12. Gwee KA, Wee S, Wong ML, et al. The prevalence, symptom characteristics, and impact of irritable bowel syndrome in an Asian urban community. Am J Gastroenterol. 2004 May;99(5):924-31.[Abstract]
13. Creed F. Review article: the incidence and risk factors for irritable bowel syndrome in population-based studies. Aliment Pharmacol Ther. 2019 Sep;50(5):507-16.[Abstract]
14. Saito YA, Schoenfeld P, Locke GR 3rd. The epidemiology of irritable bowel syndrome in North America: a systematic review. Am J Gastroenterol. 2002 Aug;97(8):1910-5.[Abstract]
15. Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012 Jul;10(7):712-21.e4.[Abstract][Full Text]
16. Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA. 2015 Mar 3;313(9):949-58.[Abstract]
17. Longstreth GF, Wolde-Tsadik G. Irritable bowel syndrome type symptoms in HMO examinees. Prevalence, demographics, and clinical correlates. Dig Dis Sci. 1993 Sep;38(9):1581-9.[Abstract]
18. Oka P, Parr H, Barberio B, et al. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020 Oct;5(10):908-17.[Abstract]
19. Saito YA, Petersen GM, Larson JJ, et al. Familial aggregation of irritable bowel syndrome: a family case-control study. Am J Gastroenterol. 2010 Apr;105(4):833-41.[Abstract][Full Text]
20. Walker EA, Katon WJ, Roy-Byrne PP, et al. Histories of sexual victimization in patients with irritable bowel syndrome or inflammatory bowel disease. Am J Psychiatry. 1993 Oct;150(10):1502-6.[Abstract]
21. Drossman DA, Talley NJ, Leserman J, et al. Sexual and physical abuse and gastrointestinal illness. Review and recommendations. Ann Intern Med. 1995 Nov 15;123(10):782-94.[Abstract]
22. Kanuri N, Cassell B, Bruce SE, et al. The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS). Neurogastroenterol Motil. 2016 Oct;28(10):1508-17.[Abstract][Full Text]
23. Chiaffarino F, Cipriani S, Ricci E, et al. Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis. Arch Gynecol Obstet. 2021 Jan;303(1):17-25.[Abstract][Full Text]
24. Klem F, Wadhwa A, Prokop LJ, et al. Prevalence, risk factors, and outcomes of irritable bowel syndrome after infectious enteritis: a systematic review and meta-analysis. Gastroenterology. 2017 Apr;152(5):1042-54.[Abstract]
25. Burns G, Carroll G, Mathe A, et al. Evidence for local and systemic immune activation in functional dyspepsia and the irritable bowel syndrome: a systematic review. Am J Gastroenterol. 2019 Mar;114(3):429-36.[Abstract]
26. Krammer L, Sowa AS, Lorentz A. Mast cells in irritable bowel syndrome: a systematic review. J Gastrointestin Liver Dis. 2019 Dec 9;28(4):463-72.[Abstract][Full Text]
27. Ahmad OF, Akbar A. Microbiome, antibiotics and irritable bowel syndrome. Br Med Bull. 2016 Dec;120(1):91-9.[Abstract][Full Text]
28. Liu HN, Wu H, Chen YZ, et al. Altered molecular signature of intestinal microbiota in irritable bowel syndrome patients compared with healthy controls: a systematic review and meta-analysis. Dig Liver Dis. 2017 Apr;49(4):331-7.[Abstract]
29. Ghoshal UC, Nehra A, Mathur A, et al. A meta-analysis on small intestinal bacterial overgrowth in patients with different subtypes of irritable bowel syndrome. J Gastroenterol Hepatol. 2020 Jun;35(6):922-31.[Abstract]
30. Slattery SA, Niaz O, Aziz Q, et al. Systematic review with meta-analysis: the prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhoea. Aliment Pharmacol Ther. 2015 Jul;42(1):3-11.[Abstract][Full Text]
31. Ng QX, Soh AYS, Loke W, et al. Systematic review with meta-analysis: The association between post-traumatic stress disorder and irritable bowel syndrome. J Gastroenterol Hepatol. 2019 Jan;34(1):68-73.[Abstract]
32. Kellow JE, Azpiroz F, Delvaux M, et al. Applied principles of neurogastroenterology: physiology/motility sensation. Gastroenterology. 2006 Apr;130(5):1412-20.[Abstract]
33. Ritchie J. Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut. 1973 Feb;14(2):125-32.[Abstract][Full Text]
34. Shian B, Larson ST. Abdominal wall pain: clinical evaluation, differential diagnosis, and treatment. Am Fam Physician. 2018 Oct 1;98(7):429-36.[Abstract]
35. National Institute for Health and Care Excellence. Irritable bowel syndrome in adults: diagnosis and management. Apr 2017 [internet publication].[Full Text]
36. Fu Y, Wang L, Xie C, et al. Comparison of non-invasive biomarkers faecal BAFF, calprotectin and FOBT in discriminating IBS from IBD and evaluation of intestinal inflammation. Sci Rep. 2017 Jun 1;7(1):2669.[Abstract][Full Text]
37. National Institute for Health and Care Excellence. Suspected cancer: recognition and referral. Oct 2023 [internet publication].[Full Text]
38. National Institute for Health and Care Excellence. Quantitative faecal immunochemical testing to guide colorectal cancer pathway referral in primary care. Aug 2023 [internet publication].[Full Text]
39. Lacy BE, Pimentel M, Brenner DM, et al. ACG clinical guideline: management of irritable bowel syndrome. Am J Gastroenterol. 2021 Jan 1;116(1):17-44.[Abstract][Full Text]
40. Smalley W, Falck-Ytter C, Carrasco-Labra A, et al. AGA clinical practice guidelines on the laboratory evaluation of functional diarrhea and diarrhea-predominant irritable bowel syndrome in adults (IBS-D). Gastroenterology. 2019 Sep;157(3):851-4.[Abstract][Full Text]
41. Waugh N, Cummins E, Royle P, et al. Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation. Health Technol Assess. 2013 Nov;17(55):1-211.[Abstract]
42. Menees SB, Powell C, Kurlander J, et al. A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol. 2015 Mar;110(3):444-54.[Abstract]
43. Ricciuto A, Griffiths AM. Clinical value of fecal calprotectin. Crit Rev Clin Lab Sci. 2019 Aug;56(5):307-20.[Abstract]
44. Lewis NR, Scott BB. Systematic review: the use of serology to exclude or diagnose coeliac disease (a comparison of the endomysial and tissue transglutaminase antibody tests). Aliment Pharmacol Ther. 2006 Jul 1;24(1):47-54.[Abstract][Full Text]
45. Irvine AJ, Chey WD, Ford AC. Screening for celiac disease in irritable bowel syndrome: an updated systematic review and meta-analysis. Am J Gastroenterol. 2017 Jan;112(1):65-76.[Abstract][Full Text]
46. Pattni SS, Brydon WG, Dew T, et al. Fibroblast growth factor 19 in patients with bile acid diarrhoea: a prospective comparison of FGF19 serum assay and SeHCAT retention. Aliment Pharmacol Ther. 2013 Oct;38(8):967-76.[Abstract][Full Text]
47. Koide A, Yamaguchi T, Odaka T, et al. Quantitative analysis of bowel gas using plain abdominal radiograph in patients with irritable bowel syndrome. Am J Gastroenterol. 2000 Jul;95(7):1735-41.[Abstract]
48. Miehlke S, Guagnozzi D, Zabana Y, et al. European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United European Gastroenterol J. 2021 Feb 22;9(1):13-37.[Abstract][Full Text]
49. Roszkowska A, Pawlicka M, Mroczek A, et al. Non-celiac gluten sensitivity: a review. Medicina (Kaunas). 2019 May 28;55(6):222.[Abstract][Full Text]
50. Quigley EM, Quera R. Small intestinal bacterial overgrowth: roles of antibiotics, prebiotics, and probiotics. Gastroenterology. 2006 Feb;130(2 suppl 1):S78-90.[Abstract]
51. Manning AP, Thompson WG, Heaton KW, et al. Towards a positive diagnosis of irritable bowel. BMJ. 1978 Sep 2;2(6138):653-4.
52. ASGE Standards of Practice Committee, Storm AC, Fishman DS, et al. American Society for Gastrointestinal Endoscopy guideline on informed consent for GI endoscopic procedures. Gastrointest Endosc. 2022 Feb;95(2):207-15.[Abstract][Full Text]
53. Vasant DH, Paine PA, Black CJ, et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut. 2021 Jul;70(7):1214-40.[Abstract][Full Text]
54. Bosman M, Elsenbruch S, Corsetti M, et al. The placebo response rate in pharmacological trials in patients with irritable bowel syndrome: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2021 Jun;6(6):459-73.[Abstract]
55. Nunan D, Cai T, Gardener AD, et al. Physical activity for treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2022 Jun 29;(6):CD011497.[Abstract][Full Text]
56. Chey WD, Hashash JG, Manning L, et al. AGA clinical practice update on the role of diet in irritable bowel syndrome: expert review. Gastroenterology. 2022 May;162(6):1737-45.e5.[Abstract][Full Text]
57. McIntosh K, Reed DE, Schneider T, et al. FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial. Gut. 2017 Jul;66(7):1241-51.[Abstract]
58. Böhn L, Störsrud S, Liljebo T, et al. Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trial. Gastroenterology. 2015 Nov;149(6):1399-407.[Abstract][Full Text]
59. Marsh A, Eslick EM, Eslick GD. Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. Eur J Nutr. 2016 Apr;55(3):897-906.[Abstract]
60. Varjú P, Farkas N, Hegyi P, et al. Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: a meta-analysis of clinical studies. PLoS One. 2017 Aug 14;12(8):e0182942.[Abstract][Full Text]
61. Altobelli E, Del Negro V, Angeletti PM, et al. Low-FODMAP diet improves irritable bowel syndrome symptoms: a meta-analysis. Nutrients. 2017 Aug 26;9(9):E940.[Abstract][Full Text]
62. van Lanen AS, de Bree A, Greyling A. Efficacy of a low-FODMAP diet in adult irritable bowel syndrome: a systematic review and meta-analysis. Eur J Nutr. 2021 Sep;60(6):3505-22.[Abstract][Full Text]
63. Dionne J, Ford AC, Yuan Y, et al. A systematic review and meta-analysis evaluating the efficacy of a gluten-free diet and a low FODMAPs diet in treating symptoms of irritable bowel syndrome. Am J Gastroenterol. 2018 Sep;113(9):1290-300.[Abstract]
64. Rao SS, Yu S, Fedewa A. Systematic review: dietary fibre and FODMAP-restricted diet in the management of constipation and irritable bowel syndrome. Aliment Pharmacol Ther. 2015 Jun;41(12):1256-70.[Abstract][Full Text]
65. Krogsgaard LR, Lyngesen M, Bytzer P. Systematic review: quality of trials on the symptomatic effects of the low FODMAP diet for irritable bowel syndrome. Aliment Pharmacol Ther. 2017 Jun;45(12):1506-13.[Abstract]
66. Black CJ, Staudacher HM, Ford AC. Efficacy of a low FODMAP diet in irritable bowel syndrome: systematic review and network meta-analysis. Gut. 2022 Jun;71(6):1117-26.[Abstract]
67. Carbone F, Van den Houte K, Besard L, et al. Diet or medication in primary care patients with IBS: the DOMINO study - a randomised trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute. Gut. 2022 Nov;71(11):2226-32.[Abstract][Full Text]
68. Wang XJ, Camilleri M, Vanner S, et al. Review article: biological mechanisms for symptom causation by individual FODMAP subgroups - the case for a more personalised approach to dietary restriction. Aliment Pharmacol Ther. 2019 Sep;50(5):517-29.[Abstract]
69. Ford AC, Moayyedi P, Chey WD, et al. American College of Gastroenterology monograph on management of irritable bowel syndrome. Am J Gastroenterol. 2018 Jun;113(suppl 2):1-18.[Abstract][Full Text]
70. Nordin E, Brunius C, Landberg R, et al. Fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs), but not gluten, elicit modest symptoms of irritable bowel syndrome: a double-blind, placebo-controlled, randomized three-way crossover trial. Am J Clin Nutr. 2022 Feb 9;115(2):344-52.[Abstract][Full Text]
71. World Gastroenterology Organisation. Global guidelines: probiotics and prebiotics. Feb 2023 [internet publication].[Full Text]
72. Liang D, Longgui N, Guoqiang X. Efficacy of different probiotic protocols in irritable bowel syndrome: a network meta-analysis. Medicine (Baltimore). 2019 Jul;98(27):e16068.[Abstract][Full Text]
73. Ford AC, Harris LA, Lacy BE, et al. Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Aliment Pharmacol Ther. 2018 Nov;48(10):1044-60.[Abstract][Full Text]
74. Su GL, Ko CW, Bercik P, et al. AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology. 2020 Aug;159(2):697-705.[Abstract][Full Text]
75. Yuan F, Ni H, Asche CV, et al. Efficacy of Bifidobacterium infantis 35624 in patients with irritable bowel syndrome: a meta-analysis. Curr Med Res Opin. 2017 Jul;33(7):1191-7.[Abstract]
76. Nagarajan N, Morden A, Bischof D, et al. The role of fiber supplementation in the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2015 Sep;27(9):1002-10.[Abstract]
77. Ruepert L, Quartero AO, de Wit NJ, et al. Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2011 Aug 10;(8):CD003460.[Abstract][Full Text]
78. Ford AC, Talley NJ, Spiegel BM, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ. 2008 Nov 13;337:a2313.[Abstract][Full Text]
79. Chang L, Sultan S, Lembo A, et al. AGA clinical practice guideline on the pharmacological management of irritable bowel syndrome with constipation. Gastroenterology. 2022 Jul;163(1):118-36.[Abstract][Full Text]
80. Black CJ, Burr NE, Quigley EMM, et al. Efficacy of secretagogues in patients with irritable bowel syndrome with constipation: systematic review and network meta-analysis. Gastroenterology. 2018 Dec;155(6):1753-63.[Abstract][Full Text]
81. Thomas RH, Allmond K. Linaclotide (Linzess) for irritable bowel syndrome with constipation and for chronic idiopathic constipation. P T. 2013 Mar;38(3):154-60.[Abstract][Full Text]
82. Shah ED, Kim HM, Schoenfeld P. Efficacy and tolerability of guanylate cyclase-C agonists for irritable bowel syndrome with constipation and chronic idiopathic constipation: a systematic review and meta-analysis. Am J Gastroenterol. 2018 Mar;113(3):329-38.[Abstract]
83. Drossman DA, Chey WD, Johanson JF, et al. Clinical trial: lubiprostone in patients with constipation-associated irritable bowel syndrome - results of two randomized, placebo-controlled studies. Aliment Pharmacol Ther. 2009 Feb 1;29(3):329-41.[Abstract]
84. Li F, Fu T, Tong WD, et al. Lubiprostone is effective in the treatment of chronic idiopathic constipation and irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials. Mayo Clin Proc. 2016 Apr;91(4):456-68.[Abstract]
85. Vakil N. Commentary: tegaserod and IBS, two decades on. Aliment Pharmacol Ther. 2020 Jan;51(1):200-1.[Abstract][Full Text]
86. Sayuk GS, Tack J. Tegaserod: What's old is new again. Clin Gastroenterol Hepatol. 2022 Oct;20(10):2175-2184.e19.[Abstract][Full Text]
87. Alfasigma USA, Inc. ZELNORM® (tegaserod) notice of withdrawal from market. Jun 2022 [internet publication]. [Full Text]
88. Lembo A, Sultan S, Chang L, et al. AGA clinical practice guideline on the pharmacological management of irritable bowel syndrome with diarrhea. Gastroenterology. 2022 Jul;163(1):137-51.[Abstract][Full Text]
89. Dove LS, Lembo A, Randall CW, et al. Eluxadoline benefits patients with irritable bowel syndrome with diarrhea in a phase 2 study. Gastroenterology. 2013 Aug;145(2):329-38.e1[Abstract][Full Text]
90. US Food and Drug Administration. FDA drug safety communication: FDA warns about increased risk of serious pancreatitis with irritable bowel drug Viberzi (eluxadoline) in patients without a gallbladder. Mar 2017 [internet publication].[Full Text]
91. Andresen V, Montori VM, Keller J, et al. Effects of 5-hydroxytryptamine (serotonin) type 3 antagonists on symptom relief and constipation in nonconstipated irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials. Clin Gastroenterol Hepatol. 2008 May;6(5):545-55.[Abstract]
92. Zheng Y, Yu T, Tang Y, et al. Efficacy and safety of 5-hydroxytryptamine 3 receptor antagonists in irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2017 Mar 14;12(3):e0172846.[Abstract][Full Text]
93. Ford AC, Brandt LJ, Young C, et al. Efficacy of 5-HT3 antagonists and 5-HT4 agonists in irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol. 2009 Jul;104(7):1831-43.[Abstract]
94. Menees SB, Maneerattannaporn M, Kim HM, et al. The efficacy and safety of rifaximin for the irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol. 2012 Jan;107(1):28-35; quiz 36.[Abstract]
95. Pimentel M, Lembo A, Chey WD, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011 Jan 6;364(1):22-32.[Abstract][Full Text]
96. Li J, Zhu W, Liu W, et al. Rifaximin for irritable bowel syndrome: a meta-analysis of randomized placebo-controlled trials. Medicine (Baltimore). 2016 Jan;95(4):e2534.[Abstract][Full Text]
97. Camilleri M, Boeckxstaens G. Dietary and pharmacological treatment of abdominal pain in IBS. Gut. 2017 May;66(5):966-74.[Abstract]
98. Alammar N, Wang L, Saberi B, et al. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med. 2019 Jan 17;19(1):21.[Abstract][Full Text]
99. Weerts ZZRM, Masclee AAM, Witteman BJM, et al. Efficacy and safety of peppermint oil in a randomized, double-blind trial of patients with irritable bowel syndrome. Gastroenterology. 2020 Jan;158(1):123-36.[Abstract]
100. Rahimi R, Nikfar S, Rezaie A, et al. Efficacy of tricyclic antidepressants in irritable bowel syndrome: a meta-analysis. World J Gastroenterol. 2009 Apr 7;15(13):1548-53.[Abstract][Full Text]
101. Xie C, Tang Y, Wang Y, et al. Efficacy and safety of antidepressants for the treatment of irritable bowel syndrome: a meta-analysis. PLoS One. 2015 Aug 7;10(8):e0127815.[Abstract][Full Text]
102. Black CJ, Thakur ER, Houghton LA, et al. Efficacy of psychological therapies for irritable bowel syndrome: systematic review and network meta-analysis. Gut. 2020 Aug;69(8):1441-51.[Abstract]
103. Barbara G, Grover M, Bercik P, et al. Rome Foundation Working Team report on post-infection irritable bowel syndrome. Gastroenterology. 2019 Jan;156(1):46-58.e7.[Abstract][Full Text]
104. El-Salhy M, Mazzawi T. Fecal microbiota transplantation for managing irritable bowel syndrome. Expert Rev Gastroenterol Hepatol. 2018 May;12(5):439-45.[Abstract]
105. Jeffery IB, Das A, O'Herlihy E, et al. Differences in fecal microbiomes and metabolomes of people with vs without irritable bowel syndrome and bile acid malabsorption. Gastroenterology. 2020 Mar;158(4):1016-28.e8.[Abstract][Full Text]
106. Pittayanon R, Lau JT, Yuan Y, et al. Gut microbiota in patients with irritable bowel syndrome-a systematic review. Gastroenterology. 2019 Jul;157(1):97-108.[Abstract][Full Text]
107. Aroniadis OC, Brandt LJ, Oneto C, et al. Faecal microbiota transplantation for diarrhoea-predominant irritable bowel syndrome: a double-blind, randomised, placebo-controlled trial. Lancet Gastroenterol Hepatol. 2019 Sep;4(9):675-85.[Abstract]
108. El-Salhy M, Hatlebakk JG, Gilja OH, et al. Efficacy of faecal microbiota transplantation for patients with irritable bowel syndrome in a randomised, double-blind, placebo-controlled study. Gut. 2020 May;69(5):859-67.[Abstract][Full Text]
109. Ianiro G, Eusebi LH, Black CJ, et al. Systematic review with meta-analysis: efficacy of faecal microbiota transplantation for the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2019 Aug;50(3):240-8.[Abstract][Full Text]
110. Xu D, Chen VL, Steiner CA, et al. Efficacy of fecal microbiota transplantation in irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol. 2019 Jul;114(7):1043-50.[Abstract][Full Text]
111. Qi Q, Zhang Y, Chen F, et al. Ramosetron for the treatment of irritable bowel syndrome with diarrhea: a systematic review and meta-analysis of randomized controlled trials. BMC Gastroenterol. 2018 Jan 8;18(1):5.[Abstract][Full Text]
112. Black CJ, Burr NE, Camilleri M, et al. Efficacy of pharmacological therapies in patients with IBS with diarrhoea or mixed stool pattern: systematic review and network meta-analysis. Gut. 2020 Jan;69(1):74-82.[Abstract][Full Text]
113. Fukudo S, Kinoshita Y, Okumura T, et al. Ramosetron reduces symptoms of irritable bowel syndrome with diarrhea and improves quality of life in women. Gastroenterology. 2016 Feb;150(2):358-66.[Abstract][Full Text]
114. Garsed K, Chernova J, Hastings M, et al. A randomised trial of ondansetron for the treatment of irritable bowel syndrome with diarrhoea. Gut. 2014 Oct;63(10):1617-25.[Abstract][Full Text]
115. Jung HK, Choung R, Locke G. Diarrhea predominant irritable bowel syndrome is associated with diverticulosis: a population based study. Am J Gastroenterol. 2010 Mar;105(3):652-61.[Abstract][Full Text]
116. Zhang QE, Wang F, Qin G, et al. Depressive symptoms in patients with irritable bowel syndrome: a meta-analysis of comparative studies. Int J Biol Sci. 2018 Aug 15;14(11):1504-12.[Abstract][Full Text]
117. Wang B, Duan R, Duan L. Prevalence of sleep disorder in irritable bowel syndrome: a systematic review with meta-analysis. Saudi J Gastroenterol. 2018 May-Jun;24(3):141-50.[Abstract][Full Text]
118. Li Z, Huang W, Wang X, et al. The relationship between lower urinary tract symptoms and irritable bowel syndrome: a meta-analysis of cross-sectional studies. Minerva Urol Nefrol. 2018 Aug;70(4):386-92.[Abstract][Full Text]