Emerging therapies in the management of Irritable Bowel Syndrome (IBS)

ABSTRACT

Introduction

Irritable bowel syndrome (IBS) is a symptom-based disorder of chronic abdominal pain and altered bowel habits. The pathogenesis of IBS is multifactorial, leading to the potential for the development of diverse treatment strategies. This mechanistic heterogeneity suggests that available therapies will only prove effective in a subset of IBS sufferers. Current US Food and Drug Administration (FDA) approved therapies for IBS with diarrhea (IBS-D) and IBS with constipation (IBS-C) are reviewed. Limited symptom responses and side effect experiences lead to considerable patient dissatisfaction with currently available IBS treatments. Only a small percentage of IBS patients are on prescription therapies underscoring the potential market and need for additional therapeutic options.

Areas covered

Expanding on currently available therapies, the serotonergic and endogenous opioid receptor systems continue to be a focus of future IBS treatment development. Additional novel emerging therapies include the endogenous cannabinoid system, bile acid secretion and sequestration, and exploit our enhanced understanding of visceral sensory signaling and intestinal secretomotor function.

Expert opinion

While challenges remain for the future development of IBS therapies, the diverse etiologies underlying the disorder present an opportunity for novel therapies. Hence, great potential is anticipated for future IBS treatment options.

KEYWORDS:

• Irritable bowel syndrome
• abdominal pain
• constipation
• diarrhea
• treatment
• pharmacotherapy

Declaration of interest

GS Sayuk is a consultant and speaker for Ironwood/AbbVie, Salix, Alnylam, and GI Health Foundation, and has research support from Allakos. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

A reviewer on this manuscript has disclosed that in the past 3 years their group has received grants from the Dutch government related to scientific work on IBS therapy: on peppermint oil and on psychological interventions and on telemonitoring. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.