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Management of IBS optimized by individualized holistic approach
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Confident diagnosis of irritable bowel syndrome depends on symptom-based criteria, and successful management relies on a holistic approach and a trusting patient-physician relationship, according to a recent clinical review.
“During the last 5 years, lifestyle and dietary interventions have become an increasingly important first-line treatment option,” William D. Chey, MD, from the University of Michigan Health System, said in a press release. “A trusting patient-physician relationship is the cornerstone of managing IBS patients.”
William D. Chey
Aiming to summarize current data on epidemiology, pathophysiology and diagnosis of IBS and provide treatment recommendations, Chey and colleagues reviewed relevant literature from 1946 through December 2014, resulting in 139 studies included in the final analysis.
While the clinical review is comprehensive, with summaries ranging from burden of illness to emerging psychological and alternative therapies, the major takeaways include:
- IBS is common, occurring in approximately 12% of the North American population.
- IBS is diagnosed by identifying symptoms (abdominal pain or cramping associated with diarrhea and/or constipation), excluding concerning features (new-onset of symptoms after age 50, family history of GI disease, GI blood loss and unexplained weight loss or iron-deficiency anemia), and prudent diagnostic testing.
- Successful management of IBS depends on a trusting and positive relationship between patients and physicians.
- A holistic approach incorporating lifestyle, diet, medications or behavioral interventions provides the best chance for sustained benefit.
“IBS remains an enigmatic cause of significant distress, morbidity, and disability,” the researchers concluded.
Diagnosis continues to depend on the identification of characteristic symptoms, but “as science advances, it’s hoped that the confident diagnosis of IBS will be aided by new biomarkers that can rule out or rule in IBS,” Chey said. – by Adam Leitenberger
Disclosure: Chey reports consulting for Astellas, AstraZeneca, Asubio, Entera, Ferring, Forest, Furiex, Ironwood, Nestle, Perrigo, Prometheus, Salix, SK, Sucampo and Takeda, and receiving research funding from Ironwood, Nestle, Perrigo and Prometheus. Please see the full study for a list of all other authors’ relevant financial disclosures.
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