Open Access
Feature Article

Irritable bowel syndrome: an update on diagnosis and management

Open Access
Feature Article

Irritable bowel syndrome: an update on diagnosis and management

YANNA KO, VINCENT HO

Figures

© TEFI/SHUTTERSTOCK
© TEFI/SHUTTERSTOCK
Dr Ko is a Gastroenterology Advanced Trainee at Campbelltown and Camden Hospital and PhD candidate in the School of Medicine, Western Sydney University, Sydney. Dr Ho is a Senior Lecturer in Medicine and a Gastroenterologist at Western Sydney University, Sydney, NSW.
 

References 

1.    Boyce PM, Talley NJ, Burke C, Koloski NA. Epidemiology of the functional gastrointestinal disorders diagnosed according to Rome II criteria: an Australian population-based study. Intern Med J 2006; 36: 28-36.
2.    Holtmann G, Ford AC, Talley NJ. Pathophysiology of irritable bowel syndrome. Lancet Gastroenterol Hepatol 2016; 1: 133-146.
3.    Farzaei MH, Bahramsoltani R, Abdollahi M, Rahimi R. The role of visceral hypersensitivity in irritable bowel syndrome: pharmacological targets and novel treatments. J Neurogastroenterol Motil 2016; 22: 558-574.
4.    Dunlop SP, Jenkins D, Spiller RC. Distinctive clinical, psychological, and histological features of postinfective irritable bowel syndrome. Am J Gastroenterol 2003; 98: 1578-1583.
5.    Chong PP, Chin VK, Looi CY, Wong WF, Madhavan P, Yong VC. The microbiome and irritable bowel syndrome - a review on the pathophysiology, current research and future therapy. Front Microbiol 2019; 10: 1136.
6.    Vasant DH, Paine PA, Black CJ, et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut 2021;  70: 1214-1240.
7.    Lacy BE, Pimentel M, Brenner D, et al. ACG Clinical Guideline: management of irritable bowel syndrome. Am J Gastroenterol 2021; 116: 17-44.
8.    Mearin F, Lacy BE, Chang L, et al. Bowel disorders. Gastroenterology 2016; 150: 1393-1407.
9.    Palsson OS, Whitehead W, Törnblom H, Sperber AD, Simren M.  Prevalence of Rome IV functional bowel disorders among adults in the  United States, Canada, and the United Kingdom. Gastroenterology  2020; 158: 1262-1273.e3.
10.    Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther 1997; 11: 395-402.
11.    Whitehead WE, Palsson O, Jones KR. Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology 2002; 122: 1140-1156.
12.    Gastroenterological Society of Australia (GESA). IBS4GPs Diagnostic-Treatment Algorithm. 2017. Available online at: http://www.ibs4gps.com (accessed July 2021).
13.    Smalley W, Falck-Ytter C, Carrasco-Labra A, Wani S, Lytvyn L, Falck-Ytter Y. AGA Clinical Practice Guidelines on the Laboratory Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome in Adults (IBS-D). Gastroenterology 2019; 157: 851-854.
14.    Dalrymple J, Bullock I. Diagnosis and management of irritable bowel syndrome in adults in primary care: summary of NICE guidance. BMJ 2008; 336: 556-558.
15.    Gastroenterological Society of Australia (GESA). Clinical update. Iron deficiency. GESA, 2015. Available online at: https://www.gesa.org.au/public/13/files/Education%20%26%20Resources/
Clinical%20Practice%20Resources/Iron%20Deficiency/Iron_Deficiency_2015.pdf
(accessed July 2021).
16.    Linedale EC, Andrews JM. Diagnosis and management of irritable bowel syndrome: a guide for the generalist. Med J Aust 2017; 207: 309-315.
17.    Canavan CJ, West J, Card T. Review article: the economic impact of the irritable bowel syndrome. Aliment Pharmacol Ther 2014; 40: 1023-1034.
18.    Rostami A, Riahi SM, Haghighi A, Saber V, Armon B, Seyyedtabaei SJ. The role of Blastocystis sp. and Dientamoeba fragilis in irritable bowel syndrome: a systematic review and meta-analysis. Parasitol Res 2017; 116: 2361-2371.
19.    Boyce JA, Assa’ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. Nutr Res 2011; 31: 61-75.
20.    Diagnosis and management of irritable bowel syndrome in adults in primary care: summary of NICE guidance. BMJ 2015; 350: h1216.
21.    Ghoshal UC, Srivastava D, Ghoshal U, Misra A. Breath tests in the diagnosis of small intestinal bacterial overgrowth in patients with irritable bowel syndrome in comparison with quantitative upper gut aspirate culture. Eur J Gastroenterol Hepatol 2014; 26: 753-760.
22.    Moayyedi P, Mearin F, Azpiroz F, et al. Irritable bowel syndrome diagnosis and management: a simplified algorithm for clinical practice. United European Gastroenterol J 2017; 5: 773-788.
23.    Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997; 32: 920-924.
24.    L Böhn, Störsrud S, Törnblom H, Bengtsson U, Simrén M. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol 2013; 108: 634-641.
25.    Fukudo S, Okumura T, Inamori M, Okuyana Y, et al. Evidence-based clinical practice guidelines for irritable bowel syndrome 2020. J Gastroenterol 2021; 56: 193-217.
26.    Bijkerk CJ, de Wit NJ, Muris JW, Whorwell PJ, Knottnerus JA, Hoes AW. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ 2009; 339: b3154.
27.    Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 2014; 146: 67-75.e5.
28.    Chumpitazi BP, Cope JL, Hollister EB, et al. Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome. Aliment Pharmacol Ther 2015; 42: 418-427.
29.    Dionne J, Ford AC, Yuan Y, et al. A systematic review and meta-analysis evaluating the efficacy of a gluten-free diet and a low FODMAPs diet in treating symptoms of irritable bowel syndrome. Am J Gastroenterol 2018; 113:  1290-1300.
30.    Schumann D, Klose P, Lauche R, Dobos G, Langhorst J, Cramer H. Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Nutrition 2018; 45: 24-31.
31.    Chey WD, Keefer L, Whelan K, Gibson PR. Behavioral and diet therapies in integrated care for patients with irritable bowel syndrome. Gastroenterology 2021; 160: 47-62.
32.    Koloski NA, Jones M, Kalantar J, Weltman M, Zaguirre J, Talley NJ. The brain-gut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study. Gut 2012; 6: 1284-1290.
33.    Spiller R, Aziz Q, Creed F. Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut 2007; 56: 1770–1798.
34.    Gastroenterological Society of Australia (GESA). IBS4GPs. Abdominal pain in IBS. GESA 2018. Available online at:  https://a9372727daad548969e006ff.blob.core.windows.net/fgid-resources/GESA_IBS4GP.com_Abdominal%20Pain.pdf (accessed July 2021).
35.    Kligler B, Chaudhary S. Peppermint oil. Am Fam Physician 2007; 75: 1027-1030.
36.    Madisch A, Holtmann H, Plein K, Hotz J. Treatment of irritable bowel syndrome with herbal preparations: results of a double-blind, randomized, placebo-controlled, multi-centre trial. Aliment Pharmacol Ther 2004; 19: 271-279.
37.    Drossman DA, Tack J, Ford AC, Szigethy E, Törnblom H, Van Oudenhove L. Neuromodulators for functional gastrointestinal disorders (disorders of gut-brain interaction): a Rome Foundation working team report. Gastroenterology 2018; 154: 1140-1171.e1.
38.    Gastroenterological Society of Australia (GESA). IBS4GPs. Chronic diarrhoea in IBS. GESA 2018. Available online at: https://a9372727daad548969e006ff.blob.core.windows.net/fgid-resources/GESA_IBS4GP.com_Chronic%20Diarrhoea.pdf (accessed July 2021).
39.    Lembo AJ, Lacy BE, Zuckerman MJ, et al. Eluxadoline for irritable bowel syndrome with diarrhea. N Engl J Med 2016; 374: 242-253.
40.    Pimentel M, Lembo A, Chey WD, Zakko SF. Rifaximin therapy for patients with irritable bowel syndrome without constipation. NEngl J Med 2011;  364: 22-32.
41.    Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006; 130: 1480-1491. 
42.    Gastroenterological Society of Australia (GESA). IBS4GPs. Information about constipation. GESA 2018. Available online at: https://a9372727daad548969e006ff.blob.core.windows.net/fgid-resources/GESA_IBS4GP.com_Constipation.pdf (accessed July 2021). 
43.    Camilleri M, Kerstens R, Rykx A, Vandeplassche L. A placebo-controlled trial of prucalopride for severe chronic constipation. N Engl J Med 2008;  358: 2344-2354.