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Masuy I, Pannemans J, Tack J. Irritable bowel syndrome: diagnosis and management. Minerva Gastroenterol Dietol. 2019;66(2):136-150doi: 10.23736/S1121-421X.19.02640-0.
Masuy, I., Pannemans, J., & Tack, J. (2020). Irritable bowel syndrome: diagnosis and management. Minerva gastroenterologica e dietologica, 66(2), 136-150. https://doi.org/10.23736/S1121-421X.19.02640-0
Masuy, Imke, et al. "Irritable bowel syndrome: diagnosis and management." Minerva gastroenterologica e dietologica vol. 66,2 (2020): 136-150. doi: https://doi.org/10.23736/S1121-421X.19.02640-0
Masuy I, Pannemans J, Tack J. Irritable bowel syndrome: diagnosis and management. Minerva Gastroenterol Dietol. 2020 Jun;66(2):136-150. doi: 10.23736/S1121-421X.19.02640-0. Epub 2019 Dec 09. PMID: 31820883.
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Minerva Gastroenterol Dietol. 2020 Jun;66(2):136-150. doi: 10.23736/S1121-421X.19.02640-0. Epub 2019 Dec 09.

Irritable bowel syndrome: diagnosis and management.

Minerva gastroenterologica e dietologica

Imke Masuy, Jasper Pannemans, Jan Tack

Affiliations

  1. Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
  2. Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium - [email protected].

PMID: 31820883 DOI: 10.23736/S1121-421X.19.02640-0

Abstract

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders (FGIDs) encountered in clinical practice. In the absence of an accurate biomarker for the disorder, IBS is mainly diagnosed based symptomology using the Rome criteria. Due to the heterogeneity of the disorder, finding the correct treatment option is often challenging. In general, lifestyle and dietary changes, including the low-FODMAP of gluten-free diet, are the first-in-line treatment for all patients. Issues with dietary changes are the strict elimination of multiple food products and hence difficult compliance to the diet. When lifestyle changes do not lead to adequate symptom relief, patients should be treated according to their predominant bowel habits and most prominent symptoms. Laxatives or prokinetics and antidiarrheals are used to treat constipation and diarrhea respectively, but have little effect on abdominal pain. To treat gastro-intestinal (GI) symptoms, antispasmodics can be attributed. Low doses of neuromodulators can help gain control over GI and central symptoms, but are also prone to more severe side effects, restricting their widespread use. Refractory IBS symptoms can be treated with probiotics, antibiotics, histamine-receptor antagonists or alternative therapy, including psychotherapy, hypnotherapy, acupuncture or phytomedicines. However, for many of these options, scientific evidence is sparse and high-quality research is often lacking, leading to inconclusive results. In general, all of the available treatment options only provide symptom relief for a subset of patients. This review provides a full overview of the diagnostic process and currently available treatment options for IBS.

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