Papale Anthony J, Flattau Robert, Vithlani Nandan, Mahajan Deepti, Nadella Sandeep
Department of Medicine, North Shore University Hospital/Zucker School of Medicine at Hofstra University, Manhasset, NY 11030, USA.
Zucker School of Medicine at Hofstra University, Hempstead, NY 11549, USA.
J Clin Med. 2024 Nov 18;13(22):6948. doi: 10.3390/jcm13226948.
Irritable bowel syndrome (IBS) is a highly prevalent and debilitating disorder of gut-brain interaction (DGBI) affecting millions globally. It imposes a significant burden on healthcare systems and is a leading cause of workplace absenteeism. IBS is classified into several subtypes based on predominant presenting symptoms, including IBS with constipation (IBS-C) and IBS with diarrhea (IBS-D), with each requiring targeted approaches to treatment. Some treatments, such as psychotherapy, dietary intervention, and medications like tricyclic antidepressants, are nonspecific and recommended for managing IBS symptoms across all subtypes. In contrast, therapies like secretagogues for IBS-C and eluxadoline or rifaximin for IBS-D are subtype-specific. However, many IBS treatments carry conditional recommendations and are based on low-certainty evidence, emphasizing the need for further research to expand the available treatment options. This review compares the latest IBS management guidelines from the American Gastroenterological Association (AGA), American College of Gastroenterology (ACG), British Society of Gastroenterology (BSG), and European Society for Neurogastroenterology and Motility (ESNM). Pharmacologic and non-pharmacologic therapies, including established and emerging interventions, will be explored to provide a comprehensive guide to management.
肠易激综合征（IBS）是一种高度普遍且使人衰弱的肠-脑互动障碍（DGBI），全球数百万人受其影响。它给医疗系统带来了巨大负担，是工作场所缺勤的主要原因。IBS根据主要表现症状分为几种亚型，包括便秘型肠易激综合征（IBS-C）和腹泻型肠易激综合征（IBS-D），每种亚型都需要针对性的治疗方法。一些治疗方法，如心理治疗、饮食干预以及三环类抗抑郁药等药物，是非特异性的，推荐用于管理所有亚型的IBS症状。相比之下，用于IBS-C的促分泌剂以及用于IBS-D的艾美拉唑或利福昔明等疗法是亚型特异性的。然而，许多IBS治疗带有有条件的推荐，且基于低确定性证据，这凸显了进一步研究以扩大可用治疗选择的必要性。本综述比较了美国胃肠病学会（AGA）、美国胃肠病学院（ACG）、英国胃肠病学会（BSG）和欧洲神经胃肠病学与动力学会（ESNM）最新的IBS管理指南。将探讨药物和非药物疗法，包括已确立的和新出现的干预措施，以提供全面的管理指南。
