Irritable bowel syndrome in new clinical practice

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Abstract

Basic component of irritable bowel syndrome (IBS) is intestine and brain dysfunction initiated by a fairly large number of risk factors. Dynamism of this system determines the variety of clinical manifestations and creates significant difficulties in diagnosis and treatment of the disease. In this regard, the initial tactics of the physician should be aimed at determining IBS phenotype in a certain patient and only after that – at selecting the appropriate treatment. In case of persistent, severe and/or aggravating symptoms or in case of adiaphoria to therapy, further testing is recommended to clarify the cause of treatment resistance and develop new tactics for patient management.

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About the authors

Igor V. Maev

Russian University of Medicine of the Ministry of Healthcare of Russia

Author for correspondence.
Email: igormaev@rambler.ru
ORCID iD: 0000-0001-6114-564X

MD, Dr. Sci. (Medicine), professor, academician of RAS, vice-rector for academic affairs

Russian Federation, Moscow

Mikhail A. Osadchuk

I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)

Email: osadchuk.mikhail@yandex.ru
ORCID iD: 0000-0003-0485-6802

MD, Dr. Sci. (Medicine), professor, head of the Department of polyclinic therapy of N.V. Sklifosovsky Institute of Clinical Medicine

Russian Federation, Moscow

Alexey M. Osadchuk

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of Russia

Email: a.m.osadchuk2020@mail.ru
ORCID iD: 0000-0002-8488-9235

MD, Dr. Sci. (Medicine), professor of the Department of gastroenterology

Russian Federation, Moscow

References

  1. Vasant D.H., Paine P.A., Black C.J. et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut. 2021; 70(7): 1214–40. https://doi.org/10.1136/gutjnl-2021-324598. PMID: 33903147.
  2. Lacy B.E., Pimentel M., Brenner D.M. et al. ACG clinical guideline: Management of irritable bowel syndrome. Am J Gastroenterol. 2021; 116(1): 17–44. https://doi.org/10.14309/ajg.0000000000001036. PMID: 33315591.
  3. Mishima Y., Ishihara S. Molecular mechanisms of microbiota-mediated pathology in irritable bowel syndrome. Int J Mol Sci. 2020; 21(22): 8664. https://doi.org/10.3390/ijms21228664. PMID: 33212919. PMCID: PMC7698457.
  4. Harris L.A., Baffy N. Modulation of the gut microbiota: A focus on treatments for irritable bowel syndrome. Postgrad Med. 2017; 129(8): 872–88. https://doi.org/10.1080/00325481.2017.1383819. PMID: 28936910.
  5. Musa M.K., Saga S., Blekken L.E. et al. The prevalence, incidence, and correlates of fecal incontinence among older people residing in care homes: A systematic review. J Am Med Dir Assoc. 2019; 20(8): 956–962.e8. https://doi.org/10.1016/j.jamda.2019.03.033. PMID: 31129021.
  6. MAP Community. The Topol Review: Preparing the healthcare workforce to deliver the digital future. February 13, 2019. URL: https://maptoolkit.wordpress.com/2019/02/13/the-topol-review-preparing-the-healthcare-workforce-to-deliver-the-digital-future/ (date of access – 27.02.2024).
  7. Ghoshal U.C. Postinfection irritable bowel syndrome. Gut Liver. 2022; 16(3): 331–40. https://doi.org/10.5009/gnl210208. PMID: 34789582. PMCID: PMC9099396.
  8. Huang K.Y., Wang F.Y., Lv M. et al. Irritable bowel syndrome: Epidemiology, overlap disorders, pathophysiology and treatment. World J Gastroenterol. 2023; 29(26): 4120–35. https://doi.org/10.3748/wjg.v29.i26.4120. PMID: 37475846 PMCID: PMC10354571.
  9. Eijsbouts C., Zheng T., Kennedy N.A. et al. Genome-wide analysis of 53,400 people with irritable bowel syndrome highlights shared genetic pathways with mood and anxiety disorders. Nat Genet. 2021; 53(11): 1543–52. https://doi.org/10.1038/s41588-021-00950-8. PMID: 34741163. PMCID: PMC8571093.
  10. El-Salhy M., Patcharatrakul T., Gonlachanvit S. The role of diet in the pathophysiology and management of irritable bowel syndrome. Indian J Gastroenterol. 2021; 40(2): 111–19. https://doi.org/10.1007/s12664-020-01144-6. PMID: 33666892. PMCID: PMC8187226.
  11. Black C.J., Ford A.C. Global burden of irritable bowel syndrome: trends, predictions and risk factors. Nat Rev Gastroenterol Hepatol. 2020; 17(8): 473–86. https://doi.org/10.1038/s41575-020-0286-8. PMID: 32296140.
  12. Kindt S., Louis H., De Schepper H. et al. Belgian consensus on irritable bowel syndrome. Acta Gastroenterol Belg. 2022; 85(2): 360–82. https://doi.org/10.51821/85.2.10100. PMID: 35709780.
  13. Kim Y.A., Cho Y.J., Kwak S.G. The Association between Helicobacter pylori infection and irritable bowel syndrome: A meta-analysis. Int J Environ Res Public Health. 2020; 17(7): 2524. https://doi.org/10.3390/ijerph17072524. PMID: 32272678. PMCID: PMC7177688.
  14. Ghoshal U.C. Marshall and Warren Lecture 2019: A paradigm shift in pathophysiological basis of irritable bowel syndrome and its implication on treatment. J Gastroenterol Hepatol. 2020; 35(5): 712–21. https://doi.org/10.1111/jgh.15032. PMID: 32162356.
  15. Rooks M.G., Garrett W.S. Gut microbiota, metabolites and host immunity. Nat Rev Immunol. 2016; 16(6): 341–52. https://doi.org/10.1038/nri.2016.42. PMID: 27231050. PMCID: PMC5541232.
  16. Patterson E., Ryan P.M., Wiley N. et al. Gamma-aminobutyric acid-producing lactobacilli positively affect metabolism and depressive-like behaviour in a mouse model of metabolic syndrome. Sci Rep. 2019; 9(1): 16323. https://doi.org/10.1038/s41598-019-51781-x. PMID: 31704943. PMCID: PMC6841999.
  17. Drossman D.A., Hasler W.L. Rome IV – functional GI disorders: Disorders of gut – brain interaction. Gastroenterology. 2016; 150(6): 1257–61. https://doi.org/10.1053/j.gastro.2016.03.035. PMID: 27147121.
  18. Маев И.В., Осадчук М.А., Бурдина В.О. с соавт. Роль эндокринных клеток толстой кишки, секретирующих вазоактивный кишечный полипептид, соматостатин и мотилин, при синдроме раздраженного кишечника, протекающем с диареей и запором. Вестник Российской академии медицинских наук. 2022; 77(2): 79–86. [Maev I.V., Osadchuk M.A., Burdina V.O. et al. The role of endocrine cells of the colon, secreting vasoactive intestinal polypeptide, somatostatin and motilin, in irritable bowel syndrome, occurring with diarrhea and constipation. Vestnik Rossiyskoy akademii meditsinskikh nauk = Annals of the Russian Academy of Medical Sciences. 2022; 77(2): 79–86 (In Russ.)]. https://doi.org/10.15690/vramn2030. EDN: EGNKPE.
  19. Karakan T., Ozkul C., Kupeli Akkol E. et al. Gut – brain – microbiota axis: Antibiotics and functional gastrointestinal disorders. Nutrients. 2021; 13(2): 389. https://doi.org/10.3390/nu13020389. PMID: 33513791. PMCID: PMC7910879.
  20. Shrestha B., Patel D., Shah H. et al. The role of gut-microbiota in the pathophysiology and therapy of irritable bowel syndrome: A systematic review. Cureus. 2022; 14(8): e28064. https://doi.org/10.7759/cureus.28064. PMID: 36127988. PMCID: PMC9477602.
  21. Herndon C.C., Wang Y.P., Lu C.L. Targeting the gut microbiota for the treatment of irritable bowel syndrome. Kaohsiung J Med Sci. 2020; 36(3): 160–70. https://doi.org/10.1002/kjm2.12154. PMID: 31782606.
  22. Aziz M.N.M., Kumar J., Muhammad Nawawi K.N. et al. Irritable bowel syndrome, depression, and neurodegeneration: A bidirectional communication from gut to brain. Nutrients. 2021; 13(9): 3061. https://doi.org/10.3390/nu13093061. PMID: 34578939. PMCID: PMC8468817.
  23. Berumen A., Edwinson A.L., Grover M. Post-infection irritable bowel syndrome. Gastroenterol Clin North Am. 2021; 50(2): 445–61. https://doi.org/10.1016/j.gtc.2021.02.007. PMID: 34024451. PMCID: PMC8144546.
  24. Parida P.K., Mishra D., Pati G.K. et al. A prospective study on incidence, risk factors, and validation of a risk score for post-infection irritable bowel syndrome in coastal eastern India. Indian J Gastroenterol. 2019; 38(2): 134–42. https://doi.org/10.1007/s12664-019-00943-w. PMID: 30949908.
  25. Gonzalez-Castro A.M., Martinez C., Salvo-Romero E. et al. Mucosal pathobiology and molecular signature of epithelial barrier dysfunction in the small intestine in irritable bowel syndrome. J Gastroenterol Hepatol. 2017; 32(1): 53–63. https://doi.org/10.1111/jgh.13417. PMID: 27087165.
  26. Schmulson M., Ghoshal U.C., Barbara G. Managing the inevitable surge of post-COVID-19 functional gastrointestinal disorders. Am J Gastroenterol. 2021; 116(1): 4–7. https://doi.org/10.14309/ajg.0000000000001062. PMID: 33273261.
  27. Маев И.В., Осадчук М.А. Заболевания желудочно-кишечного тракта в контексте инфекции COVID-19. Терапевтический архив. 2023; 95(7): 586–590. [Maev I.V., Osadchuk M.A. Diseases of the gastrointestinal tract in the context of COVID–19 infection: Present and future challenges: A review. Terapevticheskiy arkhiv = Therapeutic Archive. 2023; 95(7): 586–590 (In Russ.)]. https://doi.org/10.26442/00403660.2023.07.202282. EDN: HUECKU.
  28. Liu Y.L., Liu J.S. Irritable bowel syndrome in China: A review on the epidemiology, diagnosis, and management. Chin Med J (Engl). 2021; 134(12): 1396–401. https://doi.org/10.1097/CM9.0000000000001550. PMID: 34074848. PMCID: PMC8213251.
  29. Gwee K.A., Lee Y.Y., Suzuki H. et al. Asia-Pacific guidelines for managing functional dyspepsia overlapping with other gastrointestinal symptoms. J Gastroenterol Hepatol. 2023; 38(2): 197–209. https://doi.org/10.1111/jgh.16046. PMID: 36321167.
  30. Savarino E., Zingone F., Barberio B. et al. Functional bowel disorders with diarrhoea: Clinical guidelines of the United European Gastroenterology and European Society for Neurogastroenterology and Motility. United European Gastroenterol J. 2022; 10(6): 556–84. https://doi.org/10.1002/ueg2.12259. PMID: 35695704. PMCID: PMC9278595.
  31. Smalley W., Falck-Ytter C., Carrasco-Labra A. et al. AGA clinical practice guidelines on the laboratory evaluation of functional diarrhea and diarrhea-predominant irritable bowel syndrome in adults (IBS-D). Gastroenterology. 2019; 157(3): 851–54. https://doi.org/10.1053/j.gastro.2019.07.004. PMID: 31302098.
  32. Menees S.B., Powell C., Kurlander J. et al. A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol. 2015; 110(3): 444–54. https://doi.org/10.1038/ajg.2015.6. PMID: 25732419.
  33. Vijayvargiya P., Camilleri M. Current practice in the diagnosis of bile acid diarrhea. Gastroenterology. 2019; 156(5): 1233–38. https://doi.org/10.1053/j.gastro.2018.11.069. PMID: 30844373.
  34. Frissora C.L., Schiller L.R. Getting the BS out of irritable bowel syndrome with diarrhea (IBS-D): Let’s make a diagnosis. Curr Gastroenterol Rep. 2024; 26(1): 20–29. https://doi.org/10.1007/s11894-023-00909-1. PMID: 38158460.
  35. Barbara G., Grover M., Bercik P. et al. Rome Foundation Working Team report on post-infection irritable bowel syndrome. Gastroenterology. 2019; 156(1): 46–58.e7. https://doi.org/10.1053/j.gastro.2018.07.011. PMID: 30009817. PMCID: PMC6309514.
  36. Ruffle J.K., Tinkler L., Emmett C. et al. Constipation predominant irritable bowel syndrome and functional constipation are not discrete disorders: A machine learning approach. Am J Gastroenterol. 2021; 116(1): 142–51. https://doi.org/10.14309/ajg.0000000000000816. PMID: 32868630.
  37. Miehlke S., Guagnozzi D., Zabana Y. et al. European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United European Gastroenterol J. 2021; 9(1): 13–37. https://doi.org/10.1177/2050640620951905. PMID: 33619914. PMCID: PMC8259259.
  38. Tosto M., D’Andrea P., Salamone I. et al. Functional constipation masked as irritable bowel syndrome. BMC Gastroenterol. 2020; 20(1): 86. https://doi.org/10.1186/s12876-020-01244-9. PMID: 32252644. PMCID: PMC7132980.
  39. Bonetto S., Fagoonee S., Battaglia E. et al. Recent advances in the treatment of irritable bowel syndrome. Pol Arch Intern Med. 2021; 131(7–8): 709–15. https://doi.org/10.20452/pamw.16067. PMID: 34463082.
  40. Safwat E., Salah M., Hussein H. Faecal calprotectin levels after rifaximin treatment in patients with irritable bowel syndrome with diarrhoea: A single-center prospective study. Arab J Gastroenterol. 2020; 21(4): 273–77. https://doi.org/10.1016/j.ajg.2020.08.003. PMID: 32928705.
  41. Sayuk G.S., Waldman S.A., Brenner D.M. Mechanisms of action of current pharmacologic options for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation. Am J Gastroenterol. 2022; 117(4S): S6–S13. https://doi.org/10.14309/ajg.0000000000001687. PMID: 35354770.
  42. Sanders M.E., Merenstein D.J., Reid G. et al. Probiotics and prebiotics in intestinal health and disease: From biology to the clinic. Nat Rev Gastroenterol Hepatol. 2019; 16(10): 605–16. https://doi.org/10.1038/s41575-019-0173-3. PMID: 31296969.
  43. Adriani A., Ribaldone D.G., Astegiano M. et al. Irritable bowel syndrome: The clinical approach. Panminerva Med. 2018; 60(4): 213–22. https://doi.org/10.23736/S0031-0808.18.03541-3. PMID: 30257542.
  44. Lam C., Tan W., Leighton M. et al. A mechanistic multicentre, parallel group, randomised placebo–controlled trial of mesalazine for the treatment of IBS with diarrhoea (IBS-D). Gut. 2016; 65(1): 91–99. https://doi.org/10.1136/gutjnl-2015-309122. PMID: 25765462. PMCID: PMC4717357.

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