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New Treatment Guidelines for Irritable Bowel Syndrome

ACG Task Force offers scientifically based recommendations

New guidelines have been issued with regard to the management of irritable bowel syndrome (IBS) and chronic idiopathic constipation. The updated guidelines were published as a supplement to the August issue of the American Journal of Gastroenterology.

The American College of Gastroenterology Task Force on the Management of Functional Bowel Disorders conducted a systematic review of the literature to update guidelines on the management of IBS and chronic idiopathic constipation.

The researchers noted that there is weak evidence for the ability of specialized diets to improve symptoms of IBS, and for evidence of fiber and psyllium providing symptom relief in IBS. Weak evidence was also found for the beneficial effects of probiotics, rifaximin, antispasmodics, peppermint oil, antidepressants, a variety of psychologic interventions, and aldosterone for females.

Strong evidence was found for linaclotide and lubiprostone compared with placebo in IBS with constipation. For chronic idiopathic constipation, strong evidence was found for fiber supplements, polyethylene glycol, lactulose, sodium picosulfate, and bisacodyl, as well as for prucalopride, linaclotide, and lubiprostone.

“This new meta-analysis of the literature on the management of IBS and chronic idiopathic constipation offers physicians scientifically based guidance to make clinical decisions about these conditions based on a thorough assessment of the evidence” a coauthor said in a statement. “However, it is important that patients talk with their doctors about their treatment options, as there is no one-size-fits-all approach to managing IBS or chronic constipation.”

Sources: MedicalXpress; August 8, 2014; and ACG Monograph; August 2014.

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