A 23-year-old biology PhD candidate has experienced gastrointestinal (GI) symptoms for the past three years, including recurrent abdominal pain, bloating, and constipation. Despite trying dietary changes (gluten-free, lactose-free, and low-FODMAP), polyethylene glycol (PEG) 3350, and cognitive behavioral therapy, her symptoms persist, severely affecting her quality of life. She spends hours in the restroom, leading to missed deadlines and concerns about funding. After a thorough evaluation, she was diagnosed with irritable bowel syndrome with constipation (IBS-C) and referred to gastroenterology for further management.

IBS-C, characterized by abdominal pain and constipation, is common in women and younger individuals. It has a multifactorial pathophysiology, including gut motility changes, microbiome-immune interactions, and gut permeability. Treatments for IBS-C have evolved, with FDA-approved agents like lubiprostone, linaclotide, plecanatide, and tenapanor targeting different mechanisms to offer symptom relief. However, current therapies are not universally effective, so treatment must be individualized based on factors such as symptoms, safety, and patient preferences.

Reference: Brenner DM. Mechanism of Action Considerations in the Management of IBS-C. Gastroenterol Hepatol (N Y). 2023 Dec;19(12):749-756. PMID: 38404415; PMCID: PMC10885421.