Belgian consensus on irritable bowel syndrome

Abstract

Background: Irritable bowel syndrome (IBS) is characterised by recurrent abdominal pain related to defaecation or associated with altered stool frequency or consistency. Despite its prevalence, major uncertainties in the diagnostic and therapeutic management persist in clinical practice. Methods: A Delphi consensus was conducted by 20 experts from Belgium, and consisted of literature review and voting process on 78 statements. Grading of recommendations, assessment, development and evaluation criteria were applied to evaluate the quality of evidence. Consensus was defined as > 80 % agreement. Results: Consensus was reached for 50 statements. The Belgian consensus agreed as to the multifactorial aetiology of IBS. According to the consensus abdominal discomfort also represents a cardinal symptom, while bloating and abdominal distension often coexist. IBS needs subtyping based on stool pattern. The importance of a positive diagnosis, relying on history and clinical examination is underlined, while additional testing should remain limited, except when alarm features are present. Explanation of IBS represents a crucial part of patient management. Lifestyle modification, spasmolytics and water-solube fibres are considered first-line agents. The low FODMAP diet, selected probiotics, cognitive behavioural therapy and specific treatments targeting diarrhoea and constipation are considered appropriate. There is a consensus to restrict faecal microbiota transplantation and gluten- free diet, while other treatments are strongly discouraged. Conclusions: A panel of Belgian gastroenterologists summarised the current evidence on the aetiology, symptoms, diagnosis and treatment of IBS with attention for the specificities of the Belgian healthcare system.

Efficacy and safety of a Low-FODMAP combined with gluten-free diet in adult irritable bowel syndrome: a systematic review and meta-analysis

“…Furthermore, the evaluation of IBS symptom improvement using the IBS Symptom Severity Scale (IBS-SSS) and IBS Quality of Life (IBS-QoL) scores revealed signi cant improvements in the LF-GFD group compared to the control group. This indicates that LF-GFD intervention not only reduces speci c symptoms but also enhances overall well-being and quality of life in IBS patients [19] . These ndings are consistent with previous studies that have reported the bene cial effects of a low-FODMAP diet in IBS management.…”

Epidemiological characteristics of a population visiting a patient-centered informative website about irritable bowel syndrome

“…Continuous variables following a Gaussian distribution were expressed as mean (standard deviation) and analyzed using unpaired t-tests (Rome positive versus Rome negative) or oneway ANOVA (IBS-D versus IBS-C versus IBS-M versus IBS-U). Non-parametric continuous variables were expressed as median (range) and analyzed with Mann-make lifestyle changes with sufficient sleep, relaxation, and physical exercise (13,14).…”

Constipation-Predominant Irritable Bowel Syndrome (IBS-C): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms

“…Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by recurrent abdominal pain and discomfort associated with altered bowel habits that occur in the absence of structural and biochemical alterations or other organic gastrointestinal (GI) diseases [ 1 , 2 , 3 ].…”