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How many patients per month do you typically see with the disease addressed in this tweetorial?
1. All the following medications are approved by the US FDA for treatment of IBS-D EXCEPT:
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a. rifaximin
b. alosetron
c. eluxadoline
d. amitriptyline
2. A 34-year-old woman presents with a 9-month history of intermittent abdominal discomfort & frequent loose stools: 3–5 episodes of watery diarrhea daily, often after meals, associated with bloating and a sensation of incomplete evacuation. She denies nocturnal symptoms, weight loss, GI bleeding, or recent travel. Her physical exam is unremarkable. Basic labs (CBC, CRP, TSH, & celiac serologies) are WNL. A colonoscopy done 6 months ago was normal. Based on Rome-IV criteria, she is diagnosed with IBS-D. She has tried dietary modifications & loperamide with only minimal relief. Which of the following is the best next step?
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a. oral rifaximin 550 mg TID x 14d
b. ciprofloxacin + metronidazole for presumed small intestinal bacterial overgrowth (SIBO)
c. loperamide 2 mg after each loose stool
d. start mesalamine therapy for suspected inflammatory bowel diseas
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1 is Not at all Pertinent, 5 is Extremely Pertinent
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