{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:00:02Z","timestamp":1790661602059,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100032408","name":"Ardelyx","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100032408","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Irritable bowel syndrome with constipation (IBS\u2010C) is a common disorder of gut\u2013brain interaction that significantly impairs quality of life. Although multiple US Food and Drug Administration (FDA)\u2010approved medications have demonstrated efficacy in randomized controlled trials, less is known about patients' real\u2010world experiences and factors influencing treatment decisions. Here, we conducted social media netnography\u2014a qualitative approach for examining patient perspectives posted online on social media platforms and e\u2010health forums, exploring the perspectives and experiences of IBS\u2010C patients who report using FDA\u2010approved therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We examined publicly available posts from X and online health e\u2010forums (Reddit, WebMD,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ibspatient.org\">ibspatient.org<\/jats:ext-link>\n                      ) made between 9\/19\/2007 and 9\/12\/2024. Overall, 7328 relevant posts referencing FDA\u2010approved IBS\u2010C medications (linaclotide, lubiprostone, plecanatide, tegaserod, tenapanor) were included. We employed qualitative (open coding) and quantitative approaches (natural language processing and artificial intelligence) to analyze the posts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four major themes emerged: (i) perceived medication efficacy; (ii) treatment\u2010related burden; (iii) intentional non\u2010adherence; and (iv) barriers to adherence. Patients described heterogeneous efficacy, ranging from meaningful symptom relief to limited or no benefit. Patients discussed the biopsychosocial burden of IBS\u2010C medications (e.g., nausea, frustration, social anxiety from potential diarrheal side effects), highlighting various barriers to adherence. Barriers such as cost, insurance coverage, and personal beliefs also influenced decisions, often prompting discontinuation, dose adjustments, or pursuit of alternative therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Social media provides unique insights into IBS\u2010C patients' real\u2010world experiences with FDA\u2010approved therapies. Findings highlight variability in efficacy, biopsychosocial impacts, and adherence challenges, underscoring the need for shared decision making and proactive management of barriers to optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70432","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:37:31Z","timestamp":1788511051000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patients' Real\u2010World Experiences With Pharmacologic Therapies for Irritable Bowel Syndrome With Constipation: A Mixed\u2010Methods Analysis and Classification of Social Media and E\u2010Forum Posts"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5071-0500","authenticated-orcid":false,"given":"Carine","family":"Khalil","sequence":"first","affiliation":[{"name":"Cedars\u2010Sinai Center for Virtual Medicine and Health System Transformation  Los Angeles California USA"},{"name":"Universit\u00e9 Paris Descartes, Laboratoire LIRAES Cedars\u2010Sinai  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9519-4599","authenticated-orcid":false,"given":"Karisma K.","family":"Suchak","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Center for Virtual Medicine and Health System Transformation  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1912-0112","authenticated-orcid":false,"given":"Ivan Flores","family":"Amaro","sequence":"additional","affiliation":[{"name":"Department of Computational Biomedicine Cedars\u2010Sinai  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Krut","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Center for Virtual Medicine and Health System Transformation  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordy","family":"O'Campo","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Center for Virtual Medicine and Health System Transformation  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7709-3813","authenticated-orcid":false,"given":"Karen","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9326-7523","authenticated-orcid":false,"given":"Allistair","family":"Clark","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Center for Virtual Medicine and Health System Transformation  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9371-391X","authenticated-orcid":false,"given":"David P.","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Ardelyx  Waltham Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Funk","sequence":"additional","affiliation":[{"name":"Ardelyx  Waltham Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6416-9556","authenticated-orcid":false,"given":"Graciela","family":"Gonzalez\u2010Hernandez","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brennan M. R.","family":"Spiegel","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Center for Virtual Medicine and Health System Transformation  Los Angeles California USA"},{"name":"Karsh Division of Gastroenterology and Hepatology Cedars\u2010Sinai  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0664-9479","authenticated-orcid":false,"given":"Christopher V.","family":"Almario","sequence":"additional","affiliation":[{"name":"Cedars\u2010Sinai Center for Virtual Medicine and Health System Transformation  Los Angeles California USA"},{"name":"Karsh Division of Gastroenterology and Hepatology Cedars\u2010Sinai  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"issue":"3","key":"e_1_2_12_2_1","article-title":"Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome","volume":"9","author":"Lacy B. 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