New Guidelines for Managing Irritable Bowel Syndrome
People with irritable bowel syndrome (IBS) -- an estimated 7 percent to 10 percent of the world's population -- have a lot to contend with. The miserable task of managing unpredictable, uncomfortable and embarrassing lower-bowel activities, from diarrhea and cramps to constipation and excess gas, is bad enough.
On top of that, the name attached to the condition sounds as if it were invented by a condescending doctor just to placate a patient. There's a subtle suggestion of a certain irritability on the part of the sufferer, too.
Add to that the fact that although IBS is perhaps the disease most commonly diagnosed by gastroenterologists, nobody has yet figured out exactly what causes it -- or what to do about it. It's defined by symptoms experienced; it has no known physical, structural manifestation. As with so many poorly understood diseases, stress is among its suspected triggers. It's largely treated through lifestyle and diet adjustments.
The American College of Gastroenterology on Friday released new guidelines for managing IBS. An ACG panel reviewed all the scientific research into IBS therapies and graded each treatment according to the quality of the science behind it. The new guidelines recommend only those treatments supported by solid science; those with weak support are said to require more research before they can make the list.
Much of the information in the new guidelines is equivocal (some probiotics, or "good bacteria," for instance, may be helpful, but more data is needed before they can be recommended outright). Though many and varied treatments are evaluated, in the end very few turn out to be well supported. Among these: tricyclic antidepressants and selective serotonin reuptake inhibitors are largely effective, as are nonabsorbable antibiotics.
But the key development here is the new edict that people suffering symptoms typical of IBS without "alarm" symptoms such as bleeding or weight loss or family history of colon cancer or celiac sprue can be diagnosed without having to undergo extensive diagnostic testing. One of the common complaints from IBS sufferers is that they get the diagnostic runaround, often finding physicians skeptical or dismissive.
Do you or a loved one suffer from IBS? How do you treat it? Do you welcome the new guidelines?
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