2 Disordered bowel habits include a history of constipation and/or diarrhea. 3 The presence of disordered bowel habits is also required for a diagnosis of IBS. Pain usually occurs in the lower abdomen but can occur anywhere in the abdomen. The presence of abdominal pain is required for a diagnosis of IBS. 3 The clinical evaluation includes determining the presence of abdominal pain, assessing bowel and dietary habits, and the patient’s medical and surgical history. The diagnosis of IBS should be based on a clinical evaluation of the patient, a physical examination, and laboratory tests (minimal) and, when clinically indicated, a colonoscopy or other appropriate tests. To receive a diagnosis of IBS, individuals must have symptoms meeting the diagnostic criteria for 3 months, with the onset of initial symptoms at least 6 months before diagnosis. The current diagnostic criteria for IBS include abdominal pain at least 1 day per week during the last 3 months that is associated with at least 2 of the following 3: 2,3 The most significant change from the Rome III criteria is the elimination of the term “discomfort” from the definition, as it is vague. In 2016, the Rome III criteria were updated by a group of multinational experts in functional GI disorders. The Rome IV criteria represent the current standard for diagnosing IBS. Addressing gaps in treatment is an important priority.Irritable bowel syndrome (IBS) is a chronic, potentially disabling disorder of the gastrointestinal (GI) tract with a relapsing/remitting course in which abdominal pain is associated with defecation or changes in stool form or frequency. The negative impact of IBS-D symptoms on QOL reported by patients indicate there is an unmet need for therapies that effectively treat and manage the symptoms of this condition. The pharmacologic agents that are indicated by the FDA for the treatment of IBS-D include alosetron, eluxadoline, and rifaximin. A number of pharmacologic agents have been used to treat IBS-D despite lack of approval by the FDA for this indication. There are 3 main subtypes: IBS with prominent diarrhea (IBS-D), IBS with constipation, and IBS with mixed symptoms of both constipation and diarrhea. However, indirect costs, such as negative effect on quality of life (QOL) and work productivity, are difficult to quantify. Direct costs associated with IBS in the United States have been estimated to exceed $1 billion. IBS is associated with substantial burden, including direct medical costs and indirect costs. Irritable bowel syndrome (IBS), a complex disorder of the gastrointestinal tract, is characterized by abdominal pain associated with defecation or changes in stool form or frequency.
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