Condition

Irritable Bowel Syndrome

IBS - Chronic digestive disorder causing abdominal pain

800M

People Affected

Active Trials

64M

New Cases/Year

1,000

Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Low FODMAP Diet

75% Effectiveness• 85% Confidence• 90% Safety• 78 trials• 5K participants

MODERATE EvidenceExcellent ValueDose: Adherence to dietary guidelines, often with dietitian guidance

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-4 weeks

Duration

Initial elimination (2-6 weeks), reintroduction (6-8 weeks), personalized long-term

Response Rate

60%

Remission Rate

35%

Number Needed to Treat (NNT)

Common Side Effects:

Dietary restriction challenges: 40%

Potential impact on gut microbiome: 20%

Nutritional inadequacy (if poorly managed): 10%

Annual Cost of Care

Drug Cost

Monitoring

$800

Side Effects

Total Annual

$800

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$10,000/QALY

Cost per Remission

$2,857

Cost per Responder

$1,667

Treatment Outcomes

Primary Outcomes

IBS Symptom Severity Score (IBS-SSS)300/500 points (moderate-severe IBS)

-27% (-80 points)

Abdominal Pain Severity (VAS)6.5/10 (0=no pain, 10=worst possible pain)

-25% (-1.6 points)

Abdominal Bloating Severity (VAS)6.0/10 (0=no bloating, 10=worst possible bloating)

-28% (-1.7 points)

Bristol Stool Scale (BSS) for IBS-D6.5/7 (average score for loose/watery stools)

-31% (-2.0 points (shift towards normal consistency))

Secondary Benefits

Irritable Bowel Syndrome Quality of Life (IBS-QOL)60/100 points (lower score indicates worse QoL)

+18% (+10.8 points)

Percentage of Weeks with Adequate Relief of IBS Symptoms20% of weeks

+150% (+30 percentage points (e.g., from 20% to 50%))

Fatigue Severity Scale (FSS)5.0/7 (higher score indicates more severe fatigue)

-12% (-0.6 points)

Common Side Effects

Dietary restriction challenges

+40%

Potential impact on gut microbiome

+20%

Nutritional inadequacy (if poorly managed)

+10%

Clinical Trial Phases:

Clinical studies

Linaclotide

68% Effectiveness• 90% Confidence• 75% Safety• 26 trials• 10K participants

HIGH EvidenceGood ValueDose: 290 mcg orally once daily (IBS-C) or 145 mcg orally once daily (CIC)

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

Long-term (chronic)

Response Rate

35%

Remission Rate

15%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Diarrhea: 20%

Abdominal pain: 7%

Flatulence: 6%

Annual Cost of Care

Drug Cost

$20,000

Monitoring

$300

Side Effects

$200

Total Annual

$20,500

Cost-Effectiveness

GOOD

QALYs Gained

0.08

ICER

$85,000/QALY

Cost per Remission

$136,667

Cost per Responder

$58,571

Treatment Outcomes

Primary Outcomes

Worst Abdominal Pain Score5.5 on a 0-10 scale

-27% (-1.5 points)

Weekly Complete Spontaneous Bowel Movements (CSBMs)0.8 CSBMs/week

+163% (+1.3 CSBMs/week)

Bristol Stool Scale (BSS) Score1.8 (type 1-2)

+67% (+1.2 points)

Overall Abdominal Discomfort Score6.0 on a 0-10 scale

-30% (-1.8 points)

Secondary Benefits

Abdominal Bloating Score5.0 on a 0-10 scale

-22% (-1.1 points)

IBS-Quality of Life (IBS-QoL) Score45 points (out of 100, lower score indicates worse QoL)

+22% (+10 points)

Straining Severity Score6.5 on a 0-10 scale

-31% (-2.0 points)

Common Side Effects

Diarrhea

+20%

Abdominal pain

+7%

Flatulence

+6%

Clinical Trial Phases:

Phase 3Phase 4

Rifaximin

65% Effectiveness• 88% Confidence• 70% Safety• 24 trials• 9K participants

HIGH EvidencePoor ValueDose: 550 mg orally three times daily for 14 days

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

14-day course, potentially repeated for recurrence

Response Rate

30%

Remission Rate

10%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

100

Common Side Effects:

Nausea: 14%

Abdominal pain: 7%

Diarrhea: 5%

Annual Cost of Care

Drug Cost

$18,000

Monitoring

$200

Side Effects

$150

Total Annual

$18,350

Cost-Effectiveness

POOR

QALYs Gained

0.07

ICER

$120,000/QALY

Cost per Remission

$183,500

Cost per Responder

$61,167

Treatment Outcomes

Primary Outcomes

Abdominal Pain Severity (0-10 scale)6.5 points on 0-10 scale

-30.8% (-2.0 points)

Bloating Severity (0-10 scale)6.0 points on 0-10 scale

-25% (-1.5 points)

Bristol Stool Form Scale (BSFS) Score5.5 (loose stool)

-18.2% (-1.0 BSFS point)

IBS Symptom Severity Score (IBS-SSS)350 points (out of 500)

-25.7% (-90 points)

Secondary Benefits

IBS-Quality of Life (IBS-QOL score)60/100

+20% (+12 points)

Number of Days with Abdominal Pain (per month)20 days/month

-25% (-5 days/month)

Frequency of Urgent Bowel Movements (per day)2.5 per day

-40% (-1.0 per day)

Common Side Effects

Nausea

+14%

Abdominal pain

+7%

Diarrhea

+5%

Clinical Trial Phases:

Phase 3Phase 4

Eluxadoline

62% Effectiveness• 85% Confidence• 60% Safety• 7 trials• 6K participants

HIGH EvidencePoor ValueDose: 100 mg orally twice daily (or 75 mg twice daily for certain patients)

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

Long-term (chronic)

Response Rate

25%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

333

Common Side Effects:

Constipation: 8%

Nausea: 7%

Abdominal pain: 6%

Pancreatitis: 0.3%

Annual Cost of Care

Drug Cost

$15,000

Monitoring

$300

Side Effects

$300

Total Annual

$15,600

Cost-Effectiveness

POOR

QALYs Gained

0.06

ICER

$110,000/QALY

Cost per Remission

$195,000

Cost per Responder

$62,400

Treatment Outcomes

Primary Outcomes

Worst Abdominal Pain Score6.0 (0-10 NRS)

-41.7% (-2.5 points)

Bristol Stool Form Scale (BSFS) Score6.0 (1-7 BSFS)

-30% (-1.8 points)

Stool Urgency Score3.0 (0-4 scale)

-33.3% (-1.0 point)

Secondary Benefits

Daily Bowel Movement Frequency5.0 movements/day

-24% (-1.2 movements/day)

IBS-Quality of Life (IBS-QOL) Score65 (0-100 scale)

+18.5% (+12 points)

Abdominal Bloating Score6.0 (0-10 NRS)

-20% (-1.2 points)

Common Side Effects

Constipation

+8%

Nausea

+7%

Abdominal pain

+6%

Clinical Trial Phases:

Phase 3Phase 4

Lubiprostone

60% Effectiveness• 85% Confidence• 75% Safety• 8 trials• 7K participants

HIGH EvidenceModerate ValueDose: 8 mcg orally twice daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 weeks

Duration

Long-term (chronic)

Response Rate

28%

Remission Rate

12%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Nausea: 23%

Diarrhea: 13%

Abdominal pain: 8%

Annual Cost of Care

Drug Cost

$10,000

Monitoring

$300

Side Effects

$250

Total Annual

$10,550

Cost-Effectiveness

MODERATE

QALYs Gained

0.07

ICER

$100,000/QALY

Cost per Remission

$87,917

Cost per Responder

$37,679

Treatment Outcomes

Primary Outcomes

Global IBS Symptom Severity Score70/100 (higher score indicates worse symptoms)

-21.4% (-15 points)

Abdominal Pain Severity5.5/10 on a 0-10 scale (0=no pain, 10=worst pain)

-18.2% (-1.0 points)

Spontaneous Bowel Movement (SBM) Frequency2.0 SBMs per week

+75% (+1.5 SBMs per week)

Stool Consistency (Bristol Stool Scale)2.0 on Bristol Stool Scale (1-7, 1=hard, 7=liquid)

+50% (+1.0 points)

Secondary Benefits

IBS-Quality of Life (IBS-QOL) Score60/100 on IBS-QOL scale (0-100, higher is better QOL)

+13.3% (+8 points)

Bloating Severity6.0/10 on a 0-10 scale (0=no bloating, 10=worst bloating)

-13.3% (-0.8 points)

Straining Severity7.0/10 on a 0-10 scale (0=no straining, 10=severe straining)

-21.4% (-1.5 points)

Common Side Effects

Nausea

+23%

Diarrhea

+13%

Abdominal pain

+8%

Clinical Trial Phases:

Phase 3Phase 4

Tricyclic Antidepressants (TCAs)

55% Effectiveness• 80% Confidence• 60% Safety• 30 trials• 4K participants

MODERATE EvidenceExcellent ValueDose: 10-50 mg orally daily (e.g., Amitriptyline)

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

2-4 weeks

Duration

Long-term (chronic)

Response Rate

40%

Remission Rate

15%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Dry mouth: 25%

Constipation: 20%

Sedation: 15%

Dizziness: 10%

Annual Cost of Care

Drug Cost

$50

Monitoring

$150

Side Effects

$100

Total Annual

$300

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.1

ICER

$10,000/QALY

Cost per Remission

$2,000

Cost per Responder

$750

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+55%

Response Rate

+40%

Remission Rate

+15%

Common Side Effects

Dry mouth

+25%

Constipation

+20%

Sedation

+15%

Clinical Trial Phases:

Phase 4