Evidence-based clinical practice guidelines for irritable bowel syndrome 2020

Area of Science:

• Gastroenterology
• Clinical Practice Guidelines
• Evidence-Based Medicine

Background:

• Irritable Bowel Syndrome (IBS) management is challenging due to limited efficacy of single-agent therapies.
• The Japanese Society of Gastroenterology (JSGE) previously published IBS guidelines in 2015.
• Significant advancements in evidence, therapies, and diagnostic criteria necessitate updated guidelines.

Purpose of the Study:

• To present the second edition of the JSGE evidence-based clinical practice guidelines for Irritable Bowel Syndrome (IBS).
• To provide updated diagnostic and therapeutic algorithms for IBS management.
• To offer practical strategies for IBS diagnosis and treatment applicable globally.

Main Methods:

• Development of 41 guideline questions covering epidemiology, pathophysiology, diagnosis, and treatment.
• Inclusion of background and clinical questions with evidence levels and recommendations.
• Creation of updated diagnostic and therapeutic algorithms based on new evidence.

Main Results:

• Algorithms for IBS diagnosis are essential for patients with chronic abdominal pain or altered bowel habits.
• Colonoscopy is recommended for patients with alarm symptoms, risk factors, or abnormal findings.
• A three-step therapeutic approach is outlined, integrating diet, behavioral modification, pharmacotherapy, and psychotherapy.

Conclusions:

• The updated JSGE-IBS guidelines offer comprehensive, evidence-based strategies for IBS diagnosis and management.
• The tiered treatment approach (steps 1-3) addresses varying patient responses to therapy.
• These guidelines aim to improve patient outcomes and provide a valuable resource for clinicians worldwide.