Current and emerging drug options in the treatment of diarrhea predominant irritable bowel syndrome

Expert Opin Pharmacother. 2015;16(18):2781-92. doi: 10.1517/14656566.2015.1101449. Epub 2015 Nov 11.


Introduction: Irritable bowel syndrome diarrhea predominant (IBS-D) is a highly prevalent GI disease, affecting nearly a third of all patients diagnosed with irritable bowel syndrome. Current treatment options are limited.

Areas covered: This review discusses the pharmacotherapeutic options for IBS-D including currently used medications, the two newly FDA approved medications, as well as emerging therapies with potential benefit in IBS-D. Particular emphasis is placed on rifaximin and eluxadoline and their possible use in IBS-D.

Expert opinion: Current pharmacological treatment of IBS-D includes loperamide, bile acid sequestrants, antispasmodics, tricyclic antidepressants, alosetron, eluxadoline and rifaximin. The latter two treatments have significantly added to the pharmacotherapeutic options for patients suffering from IBS-D.

Keywords: diarrhea; eluxadoline; irritable bowel syndrome; pharmacological treatments; rifaximin.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents, Tricyclic / therapeutic use
  • Antidiarrheals / therapeutic use*
  • Carbolines / therapeutic use
  • Diarrhea / drug therapy*
  • Diarrhea / physiopathology
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Imidazoles / therapeutic use
  • Irritable Bowel Syndrome / drug therapy*
  • Irritable Bowel Syndrome / physiopathology
  • Loperamide / therapeutic use
  • Phenylalanine / analogs & derivatives
  • Phenylalanine / therapeutic use
  • Receptors, Opioid / agonists
  • Rifamycins / therapeutic use
  • Rifaximin


  • Antidepressive Agents, Tricyclic
  • Antidiarrheals
  • Carbolines
  • Gastrointestinal Agents
  • Imidazoles
  • Receptors, Opioid
  • Rifamycins
  • alosetron
  • eluxadoline
  • Phenylalanine
  • Loperamide
  • Rifaximin