Table 3.
Summary of efficacy and safety of therapies used for the management of IBS-D
| Therapy | NNT | NNH |
|---|---|---|
| Pharmacologic therapies | ||
| Antidepressants | 4.5 | 8.5a |
| TCAs [20, 78] | 4.5 and 8 | 9a and 18b |
| Alosetron [20, 78] | 7.5 | 10a and 19b |
| Antispasmodics [79] | ||
| Dicyclomine | 4 | NA |
| Hyoscine | 3 | NA |
| Eluxadoline [20] | 75 mg: 10–14 | 75 mg: 25b |
| 100 mg: 9–10 | 100 mg: 23b | |
| Rifaximin [20, 78] | 9 | 8971b |
| 11 | ||
| Nonprescription therapies | ||
| Cognitive behavioral therapy [20] | 4 | NA |
| Low FODMAP diet [79] | 5 | NA |
| Peppermint oil [20] | 3 (overall IBS symptoms) | NA |
| 4 (abdominal pain) | ||
| Probiotics [59, 80] | 7 | 35a |
NNT and NNH are provided for therapies with data available
AE adverse event, FODMAP fermentable oligo-, di-, and monosaccharides and polyols, IBS-D irritable bowel syndrome with diarrhea, NA not available, NNH number needed to harm, NNT number needed to treat, TCA tricyclic antidepressant
aNNH based on experiencing an AE
bNNH based on discontinuation due to an AE