For the first time, the American College of Gastroenterology (ACG) developed a clinical practice guideline for managing irritable bowel syndrome (IBS). ACG Clinical Guideline: Management of Irritable Bowel Syndrome (IBS) was published online in the January 2021 issue of The American Journal of Gastroenterology.
According to ACG, IBS is a “disorder of bowel function and sensation in which patients have changes in bowel habits such as constipation or diarrhea and abdominal pain, along with other symptoms including abdominal bloating, and rectal urgency with diarrhea.” The disorder is estimated to affect 4.4%-4.8% of the global population and upwards of 10-15% of the American population. It is more common in women than in men.
The guideline provides clinical recommendations for both diagnostic testing and therapeutic treatments for IBS and was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Researchers answered 25 clinically important questions on IBS including nine questions focused on diagnostic questions and 16 questions focused on therapeutic options.
The authors of the guidelines endorsed using a positive diagnostic strategy to initiate appropriate therapy as compared to a diagnostic strategy of exclusion.
According to ACG’s official announcement, there were a total of 25 recommendations, including:
- Diagnostic testing to rule out celiac disease and inflammatory bowel disease (IBD) in patients with suspected IBS and diarrhea, which is not routinely performed by many health care providers
- Recommending against routine colonoscopy in patients with IBS symptoms under age 45 who do not exhibit warning signs such as unintentional weight loss, older age of onset of symptoms, or family history of IBD, colon cancer, or other significant gastrointestinal diseases
- Treatment of IBS with constipation (IBS-C) symptoms with guanylate cyclase activators and treatment of IBS with diarrhea (IBS-D) symptoms with a gut-selective antibiotic
- The use of tricyclic antidepressants to treat global symptoms of IBS, including its key symptom, abdominal pain
- Gut-directed psychotherapies to treat overall IBS symptoms as part of a comprehensive management strategy, rather than as a last resort, that can be used in conjunction with dietary therapies and medications
CDI’s proprietary IBSchek® Capillary Collection Kit is based on the scientific findings of a 2500+ patient clinical trial that showed that anti-vinculin and anti-CdtB are effective biomarkers for the diagnosis of diarrhea-predominant or mixed-symptom IBS (IBS-D/M). Clinically validated in 2015 and revalidated internationally, IBSchek is the most reliable diagnostic blood test for IBS in the market and directly supports ACG’s guidelines for a positive diagnostic strategy.
Given the prevalence of Small Intestinal Bacterial Overgrowth (SIBO) and food sensitivities among patients with IBS, ACG’s clinical guidelines are also supported by CDI’s expansive portfolio of non-invasive at-home hydrogen and methane breath testing kits for SIBO and Intestinal Methane Overgrowth (IMO), and carbohydrate malabsorption.
ACG Clinical Guideline: Management of Irritable Bowel Syndrome (IBS) was jointly authored by Brian E. Lacy, PhD, MD, FACG; Mark Pimentel, MD, FRCPC; Darren M. Brenner, MD, FACG; William D. Chey, MD, FACG; Laurie Keefer, PhD; Millie D. Long, MD, MPH, FACG; and Baha Moshiree, MD, FACG.