Guidelines on the management of irritable bowel syndrome

Abstract

These guidelines constitute an update of the previous “Recommendations on the management of irritable bowel syndrome” issued in 2008. They have been developed by a Task Force organized by the Governing Board of the Polish Society of Gastroenterology. They discuss, with particular emphasis on new scientific data covering papers published since 2008, the aetiology, epidemiology, clinical presentation, diagnostic principles and criteria for the diagnosis, and recommendations for the treatment of irritable bowel syndrome (IBS). The English-language acronym for the syndrome (IBS) has become popular in medical and popular scientific language. It is also widely recognized by patients who identify with this diagnosis. Therefore, in the discussed guidelines, this is what we will use.

Are probiotics useful in the treatment of chronic idiopathic constipation in adults? A review of existing systematic reviews, meta-analyses, and recommendations

“…Of note, we found some papers (N = 15) that covered IBS therapeutic approaches where probiotics were recommended/evaluated as a highly recommended treatment option, but the authors of the different studies examined different IBS subtypes as mixtures or did not report on improved intestinal transit time/bowel movements frequency/stool consistency [75,87,90,[93][94][95][96][97][98][99][100][101][102][103][104]. These documents were not placed in Tables II-IV. Overall, there seemed to be an agreement that probiotics may improve intestinal motility, but medical authorities predominantly recommended probiotics as an integral part of treatment for constipation cautiously.…”

“…Probiotics contain live microorganisms, which when administered in adequate amounts confer a health benefit to the host [74]. Probiotics have been used successfully in patients with various FGIDs, and some recommendations concerning use of probiotics in clinical practice are already available [9,75]. However, their use in constipated individuals is still controversial.…”

Irritable bowel syndrome dietary modifications - what to forbid and what to recommend?

“…A systematic review found no beneficial effect with fibers, whereas meta-analysis including 906 patients showed that soluble fibers intake helps alleviate the symptoms. [18] Furthermore, dietary fiber has also other benefits. It improves body weight management, regulates blood pressure and lower blood cholesterol levels.…”

“…Main purpose is to encourage the intake of foods that individually have beneficial effects and the avoidance of unhealthy options. [18] Moreover, introducing to everyday diet foods that alleviate symptoms have to be safe and well tested.…”

“…Probiotics with a beneficial effect in IBS are: Bifidobacterium bifidum MIMBb75, Bifidobacterium infantis 35624, Bifidobacterium lactis, Escherichia coli DSM17252, Lactobacillus acidophilus SDC 2012, 2013 and Lactobacillus plantarum 299v. [18] Numerous studies conducted on this subject haven't result in any specific data. There was no research proving the efficacy of probiotic in all of symptoms.…”