What are the ACG recommendations on the management of irritable bowel syndrome (IBS)?

Updated: Dec 11, 2019
  • Author: Jenifer K Lehrer, MD; Chief Editor: BS Anand, MD  more...
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The 2009 American College of Gastroenterologists (ACG) position statement recommends addressing nongastrointestinal symptoms and comorbidities to improve health-related quality of life as well as to reduce symptom severity. Evidence considered in the position statement was insufficient to recommend exclusion diets or food allergy testing. [3]

The 2014 ACG monograph on the management of irritable bowel syndrome and chronic idiopathic constipation found insufficient evidence to recommend prebiotics or synbiotics, or loperamide, in irritable bowel syndrome, and no evidence that polyethylene glycol improved overall symptoms and pain in affected patients. [32] There was high quality of evidence to support the use of antidepressants as a class, and moderate quality of evidence in favor of fiber and psyllium, for overall symptomatic relief in irritable bowel syndrome. Strong recommendations were reported for linaclotide and lubiprostone each being superior to placebo in treating the constipation-predominant disease subtype. [32]

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