Clinical Pearls for Irritable Bowel Syndrome Management of the Diarrhea-Predominant Subtype

被引:4
作者
Lacy, Brian E. [1 ,2 ]
O'Shana, Tracia [3 ]
机构
[1] Dartmouth Coll, Hitchcock Med Ctr, Dartmouth Med Sch, Hanover, NH 03756 USA
[2] Dartmouth Hitchcock Med Ctr, GI Motil Lab, Lebanon, NH 03756 USA
[3] Dartmouth Coll, Geisel Sch Med, Hanover, NH 03755 USA
关键词
INTESTINAL BACTERIAL OVERGROWTH; DOUBLE-BLIND; HEALTH-CARE; GASTROINTESTINAL SYMPTOMS; RESOURCE UTILIZATION; WORK PRODUCTIVITY; FERMENTED MILK; ALOSETRON; WOMEN; LIFE;
D O I
10.1097/SGA.0000000000000056
中图分类号
R57 [消化系及腹部疾病];
学科分类号
100201 [内科学];
摘要
Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder that is characterized by the presence of abdominal pain or discomfort and is subtyped by the predominant stool symptoms of constipation, diarrhea, or mixed constipation and diarrhea. The diagnosis of IBS was once considered to be one of exclusion, but data now show that exhaustive tests provide very limited diagnostic yield. Instead, the symptom-based Rome criteria can be used to make a confident determination of IBS. For patients diagnosed with IBS, pharmacological decisions are based on the underlying disturbances such as abdominal pain, bowel symptoms, and urgency; how the condition affects quality of life; and symptom severity. Traditionally, treatment of IBS has focused on one or two individual symptoms rather than syndrome relief; however, emerging evidence on newer targeted treatment options is drawing clinical attention. Targeted treatment will require ongoing evaluation of disease severity, as current data show that severe IBS is more common than previously thought and severity influences treatment choices. This article reviews the disease state of IBS, answers questions about the condition, and discusses the evidence supporting current management options.
引用
收藏
页码:392 / 405
页数:14
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