Moayyedi Paul, Mearin Fermín, Azpiroz Fernando, Andresen Viola, Barbara Giovanni, Corsetti Maura, Emmanuel Anton, Hungin A Pali S, Layer Peter, Stanghellini Vincenzo, Whorwell Peter, Zerbib Frank, Tack Jan
Department of Medicine, Division of Gastroenterology, McMaster University, Hamilton, ON, Canada.
Institute of Functional and Motor Digestive Disorders, Centro Médico Teknon, Barcelona, Spain.
United European Gastroenterol J. 2017 Oct;5(6):773-788. doi: 10.1177/2050640617731968. Epub 2017 Sep 28.
Effective management of irritable bowel syndrome (IBS), a common functional gastrointestinal disorder, can be challenging for physicians because of the lack of simple diagnostic tests and the wide variety of treatment approaches available.
The objective of this article is to outline a simple algorithm for day-to-day clinical practice to help physicians navigate key stages to reaching a positive IBS diagnosis and guidance on how to prioritise the use of specific management strategies.
This algorithm was based on the opinion of an expert panel evaluating current evidence.
The key principles forming the foundation of this evidence-supported algorithm are: confidently naming and explaining an IBS diagnosis for the patient, followed by assessment of key patient characteristics likely to influence the choice of therapy, such as predominant symptoms, and exploring the patient agenda and preferences. Consultation should always include education and reassurance with an explanatory model of IBS tailored to the patient. Individualised lifestyle changes, dietary modifications, pharmacological therapies, psychological strategies or a combination of interventions may be used to optimise treatment for each patient.
The simple visual tools developed here navigate the key stages to reaching a positive diagnosis of IBS, and provide a stepwise approach to patient-centred management targeted towards the most bothersome symptoms. Establishing a strong patient-physician relationship is central to all stages of the patient journey from diagnosis to effective management.
肠易激综合征（IBS）是一种常见的功能性胃肠疾病，由于缺乏简单的诊断测试以及可用的治疗方法种类繁多，医生对其进行有效管理可能具有挑战性。
本文的目的是概述一种适用于日常临床实践的简单算法，以帮助医生在关键阶段做出IBS的阳性诊断，并指导如何优先使用特定的管理策略。
该算法基于评估当前证据的专家小组的意见。
构成这一有证据支持的算法基础的关键原则是：向患者自信地说明并解释IBS诊断，随后评估可能影响治疗选择的关键患者特征，如主要症状，并探究患者的议程和偏好。咨询应始终包括采用为患者量身定制的IBS解释模型进行教育和安抚。可采用个性化的生活方式改变、饮食调整、药物治疗、心理策略或多种干预措施相结合的方式，为每位患者优化治疗。
此处开发的简单可视化工具可指导做出IBS阳性诊断的关键阶段，并提供一种针对最困扰症状的以患者为中心的管理的逐步方法。建立牢固的医患关系是患者从诊断到有效管理的整个过程所有阶段的核心。
