Irritable bowel syndrome

ibs · society: ACG

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Summary

First-ever ACG GRADE-based clinical guideline on IBS management addressing 25 PICO questions (9 diagnostic, 16 therapeutic). Endorses positive symptom-based diagnosis over diagnosis of exclusion, with targeted serologic and fecal testing to rule out celiac disease and IBD in IBS-D. Recommends low-FODMAP diet, soluble fiber, secretagogues (linaclotide, plecanatide, lubiprostone, tegaserod) for IBS-C; rifaximin, alosetron, eluxadoline for IBS-D; TCAs and gut-directed psychotherapy across subtypes. Recommends against routine food allergy testing, PEG monotherapy for global IBS-C symptoms, and FMT.

Current guideline: ACG 2021 IBS Guideline · download Anki sub-deck

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