Evidence-Based First-Line Treatments for Irritable Bowel Syndrome: Practical Options for Primary Care Clinicians

A large, retrospective cohort study of US adults found that long-term use of some commonly prescribed medications for irritable bowel syndrome (IBS), including antidepressants and select antidiarrheal agents, was associated with an increased risk of all-cause mortality. The findings raise a critical question: How can physicians talk about that risk with patients—clearly and honestly, yet without provoking unnecessary fear? In the video above, lead author Ali Rezaie, MD, medical director of the GI Motility Program at Cedars-Sinai, discusses why clinicians should consider non-medical approaches and various FDA-approved medications for IBS diarrhea and constipation, emphasizing that these medications have undergone rigorous clinical trials and do not increase mortality risk. He also highlights lifestyle modifications and dietary approaches as first-line treatments, and notes the availability of multiple safe and effective medications for IBS.

Editors’ note: Rezaie reports relevant disclosures with Bausch Health, Ardelyx, and others.