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Insulin secretion is stimulated, glucagon and gastric acid secretion are inhibited, and GI transit and motility are decreased by incretin hormones, especially glucagon-like peptide-1 (GLP-1), which is released postprandially from L-cells lining the gut in response to food ingestion ( in vitro and in vivo , GLP-1 has been frequently demonstrated to reduce GI muscle activity via nerve-mediated mechanisms reliant on nitric oxide ( GLP-1 receptors, which are expressed in the central nervous system (CNS) in addition to peripheral tissues, are limited to neurons in the caudal nucleus of the solitary tract (NTS) and the ventrolateral medulla in the brainstem and hypothalamus ( Constipation-predominant IBS was linked to lower mucosal expression of GLP-1 receptors and serum GLP-1 concentrations ( This is the first systematic review and meta-analysis investigating GLP-1 agonists efficacy and safety in IBS patients

Pros: available at every pharmacy/grocery, 50+ year brand, laboratory tested, starter-friendly 500 mg dose, affordable entry point

Since the symptoms overlap so much, are there signs that help distinguish the two

Starting them sequentially rather than simultaneously often improves tolerability

Designed for physicians navigating uncertainty, patient demand, and long-term outcomes