Emerging treatments

Microbiota-directed therapies

Patients with IBS have significant differences in their microbiota compared with people without IBS, but it is unclear whether this represents cause or effect.[103][104][105] Some randomised placebo-controlled trials report an improvement in IBS symptoms in patients receiving faecal microbiota transplantation (FMT), while other studies report no difference in symptom control between the FMT and placebo groups.[106][107][108][109] FMT can be successfully accomplished with colonoscopy, use of nasojejunal tubes, or pills.

Ramosetron

Ramosetron, a 5HT-3 receptor antagonist, has been shown to be effective in both men and women for reducing diarrhoea and abdominal pain in diarrhoea-predominant IBS.[110][111] Constipation is a side effect in around 10% of patients.[112] It is approved for the treatment of IBS with diarrhoea in several countries, including Japan and India, but not in the US or Europe.

Ondansetron

Ondansetron, a 5HT-3 receptor antagonist, has long been used as an anti-emetic. One large prospective study demonstrated that it was modestly effective versus placebo for improving diarrhoea and well-being in patients with diarrhoea-predominant IBS.[113]

Use of this content is subject to our disclaimer