ediThe Lancet Gastroenterology & Hepatology · 2024

Personalisation of Therapy in Irritable Bowel Syndrome

Prof. Alexander C Ford, MD  ·  Christopher J Black, PhD  ·  Leeds Gastroenterology Institute  ·  2024

Enterosgel recommended as first-line therapy for IBS-D

In this landmark review published in The Lancet Gastroenterology & Hepatology, Professor Alexander C Ford and Dr Christopher J Black outline a personalised approach to IBS therapy — matching treatment selection to each patient’s predominant symptom profile.

For patients where diarrhoea and urgency are the main symptoms, the authors recommend Enterosgel® as a first-line treatment option. This is the first time Enterosgel has been formally recommended in a major international clinical review published in The Lancet — one of the world’s most respected medical journals.

How Enterosgel fits into a personalised IBS treatment pathway

Enterosgel® is recognised in this review as an effective, drug-free, first-line or early-intervention option for IBS with diarrhoea (IBS-D). It functions as an oral intestinal adsorbent, helping to manage the core symptoms of IBS-D including loose stools, diarrhoea, and urgency — the very symptoms the Lancet authors identify as the key criteria for its use.

The personalised approach advocated by Ford and Black represents a significant shift in how IBS is managed clinically. Rather than applying a one-size-fits-all treatment protocol, clinicians are now encouraged to identify the predominant symptom cluster — whether pain, bloating, constipation, or diarrhoea and urgency — and select treatments accordingly. For the diarrhoea and urgency cluster, Enterosgel® is positioned at the front of the treatment pathway.

This recommendation builds directly on the evidence generated by the RELIEVE IBS-D trial — a 440-patient, double-blind, randomised controlled trial conducted across 28 NHS sites in England, published in GUT journal in 2022, which demonstrated that 76% of patients reported adequate relief of IBS symptoms with Enterosgel.

International clinical recognition of Enterosgel for IBS

The Lancet recommendation reflects a broader trend. In recent years, Enterosgel® has become increasingly recognised by clinicians and physicians worldwide as an effective treatment for IBS. In the two years following the RELIEVE IBS-D publication, Enterosgel has been listed as an effective treatment in multiple international articles and guidelines outlining IBS management strategies — a pattern that continues to accelerate.

Enterosgel is now available on NHS prescription across England, listed on the NHS Drug Tariff, and stocked at Boots, and independent pharmacies nationwide.

About the researchers