[First Central American and Caribbean Consensus on Irritable Bowel Syndrome]

Irritable bowel syndrome is one of the most common gastrointestinal disorders seen by physicians, both in primary and secondary care. Significant advances have been made in understanding its complex pathophysiology, resulting in its reclassification as a gut-brain interaction disorder, rather than a functional gastrointestinal disorder. The condition affects between 5% and 10% of the population and, in most cases, it is characterized by having a relapsing-remitting course. This diagnosis can be made based on the clinical history with limited and judicious use of investigations, unless symptoms of alarm such as weight loss or rectal bleeding, or a family history of inflammatory bowel disease or celiac disease. The pillars of treatment include patient education about the condition, dietary changes, soluble fiber, and antispasmodic medications. Other treatments tend to be reserved for people with refractory symptoms and include central neuromodulators, intestinal secretagogues, drugs that act on opioid receptors or 5-Hydroxytryptamine or serotonin, (5-HT), or minimally absorbed antibiotics (all of which are selected according to the predominant intestinal habit), as well as psychological therapies. This consensus is the result of the joint work of representatives of the Central American and Caribbean Association of Gastroenterology, developed virtually, with the aim of presenting a series of recommendations adapted to the reality of the region and serving as a reference in clinical practice.