Korean J Gastroenterol.  2018 Nov;72(5):252-257. 10.4166/kjg.2018.72.5.252.

Review of the Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. junghk@ewha.ac.kr

Abstract

This guidance is an updated version of the irritable bowel syndrome (IBS) guidelines based on evidence-based medicine. IBS is a common chronic gastrointestinal syndrome that occurs in approximately 10% of the population and causes chronic abdominal pain as well as bowel habit changes, such as stool frequency or consistency. The final diagnosis of IBS is based on the exclusion of organic diseases that would explain the symptoms and the absence of endoscopic abnormalities. IBS can reduce the quality of life and cause a major disease burden, such as repeated examinations and continuous drug use, by mistaking organic diseases including malignancy. The major changes are as follows: 1) when to perform a colonoscopy under the impression of IBS; 2) effect of a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet; 3) impact of probiotics in IBS; and 4) role of antibiotics in IBS. The Korean Society of Neurogastroenterology and Motility recently updated these guidelines to support physicians for qualified medical services and reduce the socioeconomic burden of IBS.

Keyword

Evidence-based practice; Irritable bowel syndrome; Practice guideline

MeSH Terms

Abdominal Pain
Anti-Bacterial Agents
Colonoscopy
Diagnosis
Diet
Disaccharides
Evidence-Based Medicine
Evidence-Based Practice
Irritable Bowel Syndrome*
Korea*
Monosaccharides
Oligosaccharides
Probiotics
Quality of Life
Anti-Bacterial Agents
Disaccharides
Monosaccharides
Oligosaccharides

Reference

1. Spiller R, Aziz Q, Creed F, et al. Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut. 2007; 56:1770–1798.
Article
2. Hookway C, Buckner S, Crosland P, Longson D. Irritable bowel syndrome in adults in primary care: summary of updated NICE guidance. BMJ. 2015; 350:h701.
Article
3. Mearin F, Lacy BE. Diagnostic criteria in IBS: useful or not? Neurogastroenterol Motil. 2012; 24:791–801.
Article
4. Lee SY, Lee KJ, Kim SJ, Cho SW. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia, and irritable bowel syndrome: a population-based study. Digestion. 2009; 79:196–201.
Article
5. Lee YY, Waid A, Tan HJ, Chua AS, Whitehead WE. Rome III survey of irritable bowel syndrome among ethnic Malays. World J Gastroenterol. 2012; 18:6475–6480.
Article
6. Siah KT, Wong RK, Chan YH, Ho KY, Gwee KA. Prevalence of irritable bowel syndrome in Singapore and its association with dietary, lifestyle, and environmental factors. J Neurogastroenterol Motil. 2016; 22:670–676.
Article
7. Miwa H. Prevalence of irritable bowel syndrome in Japan: internet survey using Rome III criteria. Patient Prefer Adherence. 2008; 2:143–147.
8. Buono JL, Mathur K, Averitt AJ, Andrae DA. Economic burden of inadequate symptom control among US commercially insured patients with irritable bowel syndrome with diarrhea. J Med Econ. 2017; 20:353–362.
Article
9. Lee OY, Yoon CO. Review : evidence based guideline for diagnosis and treatment : diagnostic guideline for irritable bowel syndrome. Kor J Neurogastroenterol Motil. 2005; 11:30–35.
10. Park HJ. Review : evidence based guideline for diagnosis and treatment : therapeutic guideline for irritable bowel syndrome. Kor J Neurogastroenterol Motil. 2005; 11:36–43.
11. Park JH, Byeon JS, Shin WG, et al. Diagnosis of irritable bowel syndrome: a systematic review. Korean J Gastroenterol. 2010; 55:308–315.
Article
12. Kwon JG, Park KS, Park JH, et al. Guidelines for the treatment of irritable bowel syndrome. Korean J Gastroenterol. 2011; 57:82–99.
Article
13. Song KH, Jung HK, Kim HJ, et al. Clinical practice guidelines for irritable bowel syndrome in Korea, 2017 revised edition. J Neurogastroenterol Motil. 2018; 24:197–215.
Article
14. Hammer J, Eslick GD, Howell SC, Altiparmak E, Talley NJ. Diagnostic yield of alarm features in irritable bowel syndrome and functional dyspepsia. Gut. 2004; 53:666–672.
Article
15. Whitehead WE, Palsson OS, Feld AD, et al. Utility of red flag symptom exclusions in the diagnosis of irritable bowel syndrome. Aliment Pharmacol Ther. 2006; 24:137–146.
Article
16. Black TP, Manolakis CS, Di Palma JA. "Red flag" evaluation yield in irritable bowel syndrome. J Gastrointestin Liver Dis. 2012; 21:153–156.
Article
17. Gibson PR, Shepherd SJ. Food choice as a key management strategy for functional gastrointestinal symptoms. Am J Gastroenterol. 2012; 107:657–666.
Article
18. Iacovou M, Tan V, Muir JG, Gibson PR. The low FODMAP diet and its application in East and Southeast Asia. J Neurogastroenterol Motil. 2015; 21:459–470.
Article
19. Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014; 146:67–75.
20. Staudacher HM, Lomer MC, Anderson JL, et al. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. J Nutr. 2012; 142:1510–1518.
Article
21. Staudacher HM, Whelan K, Irving PM, Lomer MC. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet. 2011; 24:487–495.
Article
22. Pimentel M, Chow EJ, Lin HC. Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. A double-blind, randomized, placebo-controlled study. Am J Gastroenterol. 2003; 98:412–419.
Article
23. Sharara AI, Aoun E, Abdul-Baki H, Mounzer R, Sidani S, Elhajj I. A randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence. Am J Gastroenterol. 2006; 101:326–333.
Article
24. Pimentel M, Park S, Mirocha J, Kane SV, Kong Y. The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial. Ann Intern Med. 2006; 145:557–563.
25. Pimentel M, Lembo A, Chey WD, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med. 2011; 364:22–32.
Article
26. Lembo A, Pimentel M, Rao SS, et al. Repeat treatment with rifaximin is safe and effective in patients with diarrhea-predominant irritable bowel syndrome. Gastroenterology. 2016; 151:1113–1121.
Article
27. Chang L, Lembo A, Sultan S. American gastroenterological association institute technical review on the pharmacological management of irritable bowel syndrome. Gastroenterology. 2014; 147:1149–1172.
Article
28. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014; 109:1547–1561.
Article
29. Yoon JS, Sohn W, Lee OY, et al. Effect of multispecies probiotics on irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Gastroenterol Hepatol. 2014; 29:52–59.
Article
30. Cha BK, Jung SM, Choi CH, et al. The effect of a multispecies probiotic mixture on the symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Clin Gastroenterol. 2012; 46:220–227.
31. Choi CH, Jo SY, Park HJ, Chang SK, Byeon JS, Myung SJ. A randomized, double-blind, placebo-controlled multicenter trial of saccharomyces boulardii in irritable bowel syndrome: effect on quality of life. J Clin Gastroenterol. 2011; 45:679–683.
32. Sinn DH, Song JH, Kim HJ, et al. Therapeutic effect of Lactobacillus acidophilus-SDC 2012, 2013 in patients with irritable bowel syndrome. Dig Dis Sci. 2008; 53:2714–2718.
Article
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