Table 3.

Treatment Options for IBS-D

	Improvements in Symptoms					Grade*	FDA-Approved for IBS-D?
	Global Symptoms	Pain	Bloating	Stool Frequency	Stool Consistency
Alosetron	+	+	+	+		1B	Yes
Antibiotics (rifaximin)	+		+			1B	No
Antidepressants	+	+				1B	No
Loperamide				+	+	2C	No
Antispasmodics	±	+				2C	No
Probiotics (Bifidobacterial some combinations)	+					2C	No

FDA, US Food and Drug Administration; IBS-D, irritable bowel syndrome, diarrhea.

^*Recommendations are based on the balance of benefits, risks, burdens, and sometimes cost: Grade 1, strong; Grade 2, weak. Assessment of quality of evidence is according to the quality of study design, consistency of results among studies, directness, and applicability of study endpoints: Grade A, high; Grade B, moderate; grade C, low.

Adapted from ACG Task Force on IBS. Am J Gastroenterol. 2009;104(suppl 1):S1-S35.⁴⁰