Irritable bowel syndrome

Also known as: IBS · IBS-C · IBS-D

Free to read — no account needed. Sign in only to bookmark this disease and track your study progress.

United StatesACG/AGA/AASLD

Current

ACG Clinical Guideline: Management of Irritable Bowel Syndrome

American College of Gastroenterology (ACG) · 2021

This ACG guideline answers 25 clinical questions on diagnosing and treating IBS in adults using GRADE plus Delphi consensus, covering diagnostic strategy, dietary, pharmacologic and psychological therapies.

The guideline favours making a positive diagnosis using symptom criteria rather than relying on extensive exclusionary testing. source
It reviews options including a limited low-FODMAP dietary trial, secretagogues, rifaximin, and gut-directed psychotherapy. source

Verify against original ↗

EuropeUEG/EASL

Current

European guidelines on functional bowel disorders with diarrhoea: UEG and ESNM statements and recommendations

UEG / ESNM · 2022

Developed by 29 European experts, this guideline covers diagnosis and treatment of functional bowel disorders with diarrhoea, chiefly diarrhoea-predominant IBS and functional diarrhoea.

The guideline treats IBS with diarrhoea and functional diarrhoea as related, potentially overlapping conditions. source
It recommends against routine use of several tests, including microbiota composition analysis and breath testing for carbohydrate malabsorption. source

Verify against original ↗

US vs EU key differences

Scope differs: the ACG guideline covers all IBS subtypes, including constipation-predominant disease with chloride channel and guanylate cyclase activators, whereas the UEG/ESNM document is limited to functional bowel disorders with diarrhoea (IBS-D and functional diarrhoea). source
The European guideline builds evaluation for bile acid diarrhoea into the diagnostic work-up and gives a conditional recommendation for bile acid sequestrants; the 2021 ACG recommendation set does not include this step. source
The European statements explicitly advise against microbiota-composition testing, routine small intestinal bacterial overgrowth testing outside predisposing conditions, and carbohydrate malabsorption breath tests. source
Drug availability shapes the European text: it notes that antispasmodics, alosetron and eluxadoline are not uniformly available across European countries, a constraint absent from the US guideline. source
The two converge on the core work-up and management of IBS with diarrhoea: coeliac serology, faecal calprotectin, a trial of a low FODMAP diet, rifaximin, and gut-directed psychological therapy. source

What changed recently

No recorded changes yet for this disease.

See the full update feed for changes across every system.