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Gastroenterology626 papers

Irritable bowel syndrome

Last edited: 4/13/2026

Overview

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by recurrent abdominal pain associated with altered bowel habits, without identifiable structural or biochemical abnormalities 158.

Diagnosis

  • Key Diagnostic Criteria: Recurrent abdominal pain associated with defecation or changes in bowel habits 158.
  • Recommended Tests: Exclusion of organic causes through appropriate investigations (e.g., blood tests, stool analysis) 18.
  • Grading: Utilize Rome criteria for diagnosis, with specific subtypes (IBS-D, IBS-C, IBS-M) based on predominant symptoms 158.
  • Management

  • First-Line Treatments:
  • - Dietary Modifications: Low FODMAP diet 262829. - Psychological Support: Cognitive-behavioral therapy (CBT), including telephone or web-based CBT 1331.
  • Adjunctive Treatments:
  • - Pharmacological: - Antispasmodics (e.g., mebeverine) 11112. - Laxatives for IBS-C (e.g., polyethylene glycol) 11. - Antidiarrheal agents for IBS-D (e.g., loperamide) 11. - Central neuromodulators (e.g., tricyclic antidepressants, SSRIs) 2132. - Probiotics: E. coli preparation (DSM17252) 33. - Vitamin D Supplementation: Consider in deficient patients 1617.

    Special Populations

  • Pediatrics: Multidisciplinary approach including dietary interventions and psychological support 1440.
  • Elderly: Consider comorbidities and polypharmacy impacts; tailored dietary and psychological interventions 8.
  • Pregnancy: Focus on dietary modifications and non-pharmacological interventions; avoid certain medications 8.
  • Key Recommendations

  • Utilize Rome criteria for diagnosing IBS to ensure standardized identification 158 (Evidence: Strong).
  • Implement dietary modifications, particularly low FODMAP diet, as a first-line treatment 262829 (Evidence: Moderate).
  • Incorporate psychological therapies, such as CBT, to address functional aspects of IBS 1331 (Evidence: Moderate).
  • Tailor pharmacological interventions based on IBS subtype (e.g., antispasmodics for abdominal pain, laxatives for constipation) 11112 (Evidence: Moderate).
  • Consider vitamin D supplementation in patients with deficiency, given potential symptom relief 1617 (Evidence: Moderate).
  • Employ a multidisciplinary approach in pediatric patients to address both physical and psychosocial aspects 1440 (Evidence: Expert opinion).
  • References

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Journal of clinical gastroenterology 2024. link 5 Di Nardo G, Barbara G, Borrelli O, Cremon C, Giorgio V, Greco L et al.. Italian guidelines for the management of irritable bowel syndrome in children and adolescents : Joint Consensus from the Italian Societies of: Gastroenterology, Hepatology and Pediatric Nutrition (SIGENP), Pediatrics (SIP), Gastroenterology and Endoscopy (SIGE) and Neurogastroenterology and Motility (SINGEM). Italian journal of pediatrics 2024. link 6 Kashyap P, Moayyedi P, Quigley EMM, Simren M, Vanner S. Critical appraisal of the SIBO hypothesis and breath testing: A clinical practice update endorsed by the European society of neurogastroenterology and motility (ESNM) and the American neurogastroenterology and motility society (ANMS). Neurogastroenterology and motility 2024. link 7 Bárdos G. Irritable bowel syndrome (IBS): could we decide what is behind?. Biologia futura 2024. link 8 Barbara G, Cremon C, Bellini M, Corsetti M, Di Nardo G, Falangone F et al.. Italian guidelines for the management of irritable bowel syndrome: Joint Consensus from the Italian Societies of: Gastroenterology and Endoscopy (SIGE), Neurogastroenterology and Motility (SINGEM), Hospital Gastroenterologists and Endoscopists (AIGO), Digestive Endoscopy (SIED), General Medicine (SIMG), Gastroenterology, Hepatology and Pediatric Nutrition (SIGENP) and Pediatrics (SIP). Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2023. link 9 Wang C, Yin Y, Wang L, Guo X, Liu L, Qi X. Association between Helicobacter pylori infection and irritable bowel syndrome: a systematic review and meta-analysis. Postgraduate medical journal 2023. link 10 Ghoshal UC, Sachdeva S, Pratap N, Karyampudi A, Mustafa U, Abraham P et al.. Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology. Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology 2023. link 11 Lembo A, Sultan S, Chang L, Heidelbaugh JJ, Smalley W, Verne GN. AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Diarrhea. Gastroenterology 2022. link 12 Chang L, Sultan S, Lembo A, Verne GN, Smalley W, Heidelbaugh JJ. AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Constipation. Gastroenterology 2022. link 13 Scarlata K, Eswaran S, Baker JR, Chey WD. Utilization of Dietitians in the Management of Irritable Bowel Syndrome by Members of the American College of Gastroenterology. The American journal of gastroenterology 2022. link 14 Atay O, David J, Mehta A. A Hypothetical Case Example Illustrating the Importance of a Multidisciplinary Approach to Treating Chronic/Functional Abdominal Pain in Pediatric Patients. Pediatric clinics of North America 2022. link 15 Bek S, Teo YN, Tan XH, Fan KHR, Siah KTH. Association between irritable bowel syndrome and micronutrients: A systematic review. Journal of gastroenterology and hepatology 2022. link 16 Bin Y, Kang L, Lili Y. Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: a systematic review and meta-analysis. Nutricion hospitalaria 2022. link 17 Huang H, Lu L, Chen Y, Zeng Y, Xu C. The efficacy of vitamin D supplementation for irritable bowel syndrome: a systematic review with meta-analysis. Nutrition journal 2022. link 18 Grozić A, Coker K, Dussik CM, Sabir MS, Sabir Z, Bradley A et al.. Identification of putative transcriptomic biomarkers in irritable bowel syndrome (IBS): Differential gene expression and regulation of TPH1 and SERT by vitamin D. PloS one 2022. link 19 Lacy BE, Pimentel M, Brenner DM, Chey WD, Keefer LA, Long MD et al.. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. The American journal of gastroenterology 2021. link 20 Vasant DH, Paine PA, Black CJ, Houghton LA, Everitt HA, Corsetti M et al.. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut 2021. link 21 Nulsen B, LeBrett W, Drossman DA, Chang L. A survey of gastroenterologists in the United States on the use of central neuromodulators for treating irritable bowel syndrome. Alimentary pharmacology & therapeutics 2021. link 22 Silvernale C, Kuo B, Staller K. Racial disparity in healthcare utilization among patients with Irritable Bowel Syndrome: results from a multicenter cohort. Neurogastroenterology and motility 2021. link 23 Jr JM. (no title). Annals of internal medicine 2020. link 24 Li H, Xing X, Yao L, Li M, Xun Y, Yan P et al.. Assessment of the Quality and Content of Clinical Practice Guidelines on Irritable Bowel Syndrome Using the AGREE II Instrument. Digestion 2020. link 25 Grad S, Dumitrascu DL. Irritable Bowel Syndrome Subtypes: New Names for Old Medical Conditions. Digestive diseases (Basel, Switzerland) 2020. link 26 Williams M, Barclay Y, Harper L, Marchant C, Seamark L, Hickson M. Feasibility, acceptability and cost efficiency of using webinars to deliver first-line patient education for people with Irritable Bowel Syndrome as part of a dietetic-led gastroenterology service in primary care. Journal of human nutrition and dietetics : the official journal of the British Dietetic Association 2020. link 27 Denton E, Hoy R. Occupational aspects of irritable larynx syndrome. Current opinion in allergy and clinical immunology 2020. link 28 Trott N, Aziz I, Rej A, Surendran Sanders D. How Patients with IBS Use Low FODMAP Dietary Information Provided by General Practitioners and Gastroenterologists: A Qualitative Study. Nutrients 2019. link 29 Mutsekwa RN, Larkins V, Canavan R, Ball L, Angus RL. A dietitian-first gastroenterology clinic results in improved symptoms and quality of life in patients referred to a tertiary gastroenterology service. Clinical nutrition ESPEN 2019. link 30 Sabaté JM, Rivière S, Jouet P, Gastaldi-Menager C, Fagot-Campagna A, Tuppin P. Healthcare use by 30,000 patients with irritable bowel syndrome (IBS) in France: a 5-year retrospective and one-year prospective national observational study. BMC gastroenterology 2019. link 31 Cook R, Davidson P, Martin R. Telephone or internet delivered talking therapy can alleviate irritable bowel symptoms. BMJ (Clinical research ed.) 2019. link 32 Thakur ER, Shapiro J, Chan J, Lumley MA, Cully JA, Bradford A et al.. A Systematic Review of the Effectiveness of Psychological Treatments for IBS in Gastroenterology Settings: Promising but in Need of Further Study. Digestive diseases and sciences 2018. link 33 Chang L, Di Lorenzo C, Farrugia G, Hamilton FA, Mawe GM, Pasricha PJ et al.. Functional Bowel Disorders: A Roadmap to Guide the Next Generation of Research. Gastroenterology 2018. link 34 Mullish BH, Quraishi MN, Segal JP, McCune VL, Baxter M, Marsden GL et al.. The use of faecal microbiota transplant as treatment for recurrent or refractory . Gut 2018. link 35 Killian LA, Chapman-Novakofski KM, Lee SY. Questionnaire on Irritable Bowel Syndrome and Symptom Management Among Endurance Athletes Is Valid and Reliable. Digestive diseases and sciences 2018. link 36 Zhou Q, Wesselmann U, Walker L, Lee L, Zeltzer L, Verne GN. AAPT Diagnostic Criteria for Chronic Abdominal, Pelvic, and Urogenital Pain: Irritable Bowel Syndrome. The journal of pain 2018. link 37 Williams CE, Williams EA, Corfe BM. Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: what do we know and what do we need to know?. European journal of clinical nutrition 2018. link 38 Enck P, Frieling T, Schemann M. Irritable bowel syndrome – dissection of a disease. A 13-steps polemic. Zeitschrift fur Gastroenterologie 2017. link 39 Krarup AL, Engsbro ALØ, Fassov J, Fynne L, Christensen AB, Bytzer P. Danish national guideline: Diagnosis and treatment of Irritable Bowel Syndrome. Danish medical journal 2017. link 40 Hollier JM, Czyzewski DI, Self MM, Weidler EM, Smith EO, Shulman RJ. Pediatric Irritable Bowel Syndrome Patient and Parental Characteristics Differ by Care Management Type. Journal of pediatric gastroenterology and nutrition 2017. link 41 . Managing irritable bowel syndrome in children. Nursing children and young people 2016. link 42 Canavan C, West J, Card T. Calculating Total Health Service Utilisation and Costs from Routinely Collected Electronic Health Records Using the Example of Patients with Irritable Bowel Syndrome Before and After Their First Gastroenterology Appointment. PharmacoEconomics 2016. link 43 Mira JJ, Guilabert M, Sempere L, Almenta IM, Palazón JM, Ignacio-García E et al.. The irritable bowel syndrome care process from the patients´ and professionals´ views. Revista espanola de enfermedades digestivas 2015. link 44 Fukudo S, Hahm KB, Zhu Q, Sollano JD, Rani AA, Syam AF et al.. Survey of clinical practice for irritable bowel syndrome in East asian countries. Digestion 2015. link 45 Molinder H, Agréus L, Kjellström L, Walter S, Talley NJ, Andreasson A et al.. How individuals with the irritable bowel syndrome describe their own symptoms before formal diagnosis. Upsala journal of medical sciences 2015. link 46 Dinning PG, Carrington EV, Scott SM. The use of colonic and anorectal high-resolution manometry and its place in clinical work and in research. Neurogastroenterology and motility 2015. link 47 Grad S, Grad C, Baban A, Dumitraşcu D. Child abuse in the irritable bowel syndrome. Romanian journal of internal medicine = Revue roumaine de medecine interne 2014. link 48 Levy S, Segev M, Reicher-Atir R, Steinmetz A, Horev N, Niv Y et al.. Perceptions of gastroenterologists and patients regarding irritable bowel syndrome and inflammatory bowel disease. European journal of gastroenterology & hepatology 2014. link 49 Pearce L. Recovery through suggestion. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2013. link 50 Li Y, Shen B. Evaluating pouch problems. Gastroenterology clinics of North America 2012. link 51 Ness W. Individual treatment for irritable bowel syndrome. Nursing times 2012. link 52 El-Salhy M. Irritable bowel syndrome: diagnosis and pathogenesis. World journal of gastroenterology 2012. link 53 Olafsdottir LB, Gudjonsson H, Jonsdottir HH, Jonsson JS, Bjornsson E, Thjodleifsson B. Irritable bowel syndrome: physicians' awareness and patients' experience. World journal of gastroenterology 2012. link 54 Andresen V, Keller J, Pehl C, Schemann M, Preiss J, Layer P. Irritable bowel syndrome--the main recommendations. Deutsches Arzteblatt international 2011. link 55 Almansa C, Díaz-Rubio M, Rey E. The burden and management of patients with IBS: Results from a survey in spanish gastroenterologists. Revista espanola de enfermedades digestivas 2011. link 56 Katiraei P, Bultron G. Need for a comprehensive medical approach to the neuro-immuno-gastroenterology of irritable bowel syndrome. World journal of gastroenterology 2011. link 57 Elmasry MS, Blagbrough IS, Rowan MG, Saleh HM, Kheir AA, Rogers PJ. Quantitative HPLC analysis of mebeverine, mesalazine, sulphasalazine and dispersible aspirin stored in a Venalink monitored dosage system with co-prescribed medicines. Journal of pharmaceutical and biomedical analysis 2011. link 58 Bengtsson M, Ulander K, Börgdal EB, Ohlsson B. A holistic approach for planning care of patients with irritable bowel syndrome. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 2010. link 59 Walter SA, Kjellström L, Nyhlin H, Talley NJ, Agréus L. Assessment of normal bowel habits in the general adult population: the Popcol study. Scandinavian journal of gastroenterology 2010. link 60 Spiegel BM, Farid M, Esrailian E, Talley J, Chang L. Is irritable bowel syndrome a diagnosis of exclusion?: a survey of primary care providers, gastroenterologists, and IBS experts. The American journal of gastroenterology 2010. link 61 Williams MD, Ha CY, Ciorba MA. Probiotics as therapy in gastroenterology: a study of physician opinions and recommendations. Journal of clinical gastroenterology 2010. link 62 Chang L, Tong K, Ameen V. Ischemic colitis and complications of constipation associated with the use of alosetron under a risk management plan: clinical characteristics, outcomes, and incidences. The American journal of gastroenterology 2010. link 63 Enck P, Zimmermann K, Menke G, Klosterhalfen S. Randomized controlled treatment trial of irritable bowel syndrome with a probiotic E.-coli preparation (DSM17252) compared to placebo. Zeitschrift fur Gastroenterologie 2009. link 64 Lane MM, Weidler EM, Czyzewski DI, Shulman RJ. Pain symptoms and stooling patterns do not drive diagnostic costs for children with functional abdominal pain and irritable bowel syndrome in primary or tertiary care. Pediatrics 2009. link 65 Ghoshal UC, Abraham P, Bhatt C, Choudhuri G, Bhatia SJ, Shenoy KT et al.. Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force. Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology 2008. link 66 Brandt LJ. The FDA's decision-making process: isn't it time to temper the principle of protective paternalism?. The American journal of gastroenterology 2008. link 67 Foxx-Orenstein A. IBS--review and what's new. MedGenMed : Medscape general medicine 2006. link 68 Charapata C, Mertz H. Physician knowledge of Rome symptom criteria for irritable bowel syndrome is poor among non-gastroenterologists. Neurogastroenterology and motility 2006. link 69 Rubin G, De Wit N, Meineche-Schmidt V, Seifert B, Hall N, Hungin P. The diagnosis of IBS in primary care: consensus development using nominal group technique. Family practice 2006. link 70 Lacy BE, Rosemore J, Robertson D, Corbin DA, Grau M, Crowell MD. Physicians' attitudes and practices in the evaluation and treatment of irritable bowel syndrome. Scandinavian journal of gastroenterology 2006. link 71 Heading R, Bardhan K, Hollerbach S, Lanas A, Fisher G. Systematic review: the safety and tolerability of pharmacological agents for treatment of irritable bowel syndrome--a European perspective. Alimentary pharmacology & therapeutics 2006. link 72 Cash B, Sullivan S, Barghout V. Total costs of IBS: employer and managed care perspective. The American journal of managed care 2005. link 73 Lea R, Hopkins V, Hastleton J, Houghton LA, Whorwell PJ. Diagnostic criteria for irritable bowel syndrome: utility and applicability in clinical practice. Digestion 2004. link 74 Folks DG. The interface of psychiatry and irritable bowel syndrome. Current psychiatry reports 2004. link 75 Gerson CD, Gerson MJ. A collaborative health care model for the treatment of irritable bowel syndrome. 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    Original source

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