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An updated American College of Gastroenterology (ACG) Guideline (2021) for IBS was just published. Among the 25 recommendations for IBS from the ACG are: Serologic testing should be performed to rule out celiac disease in patients with IBS and diarrhea symptoms. Fecal calprotectin, fecal lactoferrin and C-reactive protein should be checked in patients without alarm features and with suspected symptoms of IBS and diarrhea to rule out inflammatory bowel disease Routine stool testing should not be performed for enteric pathogens in all IBS patients. Routine colonoscopy should not be performed in patients with IBS symptoms aged younger than 45 years without warning signs. A positive diagnostic strategy vs. a diagnostic strategy of exclusion should be used for patients with IBS symptoms to improve time to initiate appropriate therapy and cost-effectiveness. Do not test for food allergies and sensitivities unless patients have reproducible symptoms concerning a food allergy. Limited trial of a low fermentable oligosaccharides, disacchardies, monosaccharides, polyols (FODMAP) diet in patients with IBS to improve global symptoms. Anorectal physiology testing should be performed in patients with IBS and symptoms that may suggest a pelvic floor disorder and refractory constipation. Anti-spasmodics available in the United States should be used to treat global IBS. Peppermint may be used to provide relief of global symptoms. Mixed opioid agonists/antagonists should be used to treat global IBS-D symptoms Use of chloride channel activators and guanylate cyclase activators (Linzess / Constella) to treat global IBS with constipation symptoms. Use of rifaximin (Xifaxan) to treat global IBS with diarrhea symptoms. Gut-directed psychotherapy (CBT) be used to treat global IBS symptoms. Source(s): Healio Pubmed: PMID: 33315591

What motivates someone to take the step to see a healthcare professional about their digestive symptoms?

I followed the Crohn's and Colitis Congress #CCCongress over the last several days. It's an annual medically oriented meeting with doctors, researchers, industry and patient advocates focused on Inflammatory Bowel Disease (IBD). While IBD is medically different than IBS, many IBD patients have IBS-like symptoms between flares. Many of the treatment options that IBS patients use are just as relevant to an IBD patient. Many dietary modifications, therapy and often feelings of despair are also similar. The one thing not similar is an understanding that suffering from IBS has just a high impact as IBD on someone's quality of life. I'm working pretty hard to highlight the QOL issues of an IBS sufferer. Since I have both IBS and Crohn's disease, I have a perspective on both. It's sometimes a real challenge to find a doctor that will take IBS as seriously as IBD. I can tell you that they are out there. Find a new doctor, if you can, if your doctor isn't sympathetic to your QOL issues. There is no reason that you have to suffer in silence on your own.

From Pretending to Truly Being OK: A Journey From Illness to Health With Postinfection Irritable Bowel Syndrome: The Patient’s Perspective Johannah Ruddy Rome Foundation, Raleigh, North Carolina Pain is something we all experience. Growing up the oldest in a conservative, protestant, middle class family you had to tolerate pain and learn to deal with it. Getting sick was not an excuse for sympathy or a day off from school. It was almost a badge of honor because you were tough, not weak like others. Maybe that’s why, at the age of 13, when it finally came out that I was sexually abused for 4 years by my cousin, I held back communicating my deepest thoughts and feelings about the experience. Rather, I felt the need to express to my mother that I was okay, even though I wasn’t. I was a “good girl,” but was dying on the inside, and I still had to show I was okay. So, I stuffed down the emotional pain and moved on to college. I married a great guy, had 2 kids, and with great passion I started a career in health and social justice nonprofits. Although I could help vulnerable, oppressed, and ill people in similar situations, I could not reverse the trauma in my own life. I also managed through more than a dozen surgeries, the care of my son with congenital health issues, and saw family members through attempted suicides, cancer diagnosis, and death. Through it all, I had to be OK. Full story: https://www.gastrojournal.org/article/S0016-5085(18)35212-0/fulltext © 2018 by the AGA Institute

Xpert Perspectives on IBS from DDW 2018 in Washington, DC Medically orientated talk from Dr Mark Pimentel and Dr. William Chey about several research abstracts. Goal Statement:The primary goal of the educational activities is to encourage the application of the latest advances in evidence-based medicine to achieve improved outcomes for the patients affected by IBS. Educational Objectives: Upon completion of this activity, participants should be better able to: Apply evidence-based diagnostic criteria to evaluate patients presenting with symptoms of suggestive of IBS/CIC Discuss the latest data regarding treatment of patients with IBS-D Summarize recent evidence regarding treatment of patients with IBS-C/CIC http://www.gihealthfoundation.org/webcasts/IBS/2018/Xpert_Perspectives_DDW/ This material is protected by copyright and other intellectual property laws. It may not be otherwise copied, printed, transmitted, or published unless explicit permission is obtained. To request permission please contact info@GiHealthFoundation.org

Pain, by definition, is the dominant symptom experienced by patients with irritable bowel syndrome (IBS). Three out of 4 people with IBS report continuous or frequent abdominal pain, with pain the primary factor that makes their IBS severe. Importantly, and unlike chronic pain in general, IBS pain is often associated with alterations in bowel movements (diarrhea, constipation, or both) reports Dr. Drossman, a leader in IBS research and treatment. Full article: >> http://drossmancenter.com/understanding-managing-pain-irritable-bowel-syndrome-ibs-tips-insight/ © COPYRIGHT 2017 DROSSMAN CARE

I spent four days in Chicago at Digestive Disease Week (DDW) over the last week and learned a great deal about recent research related to IBS and other gastrointestinal disorders. I will summarize the highlights of the conference shortly. Stay tuned! P.S. I was the ONLY IBS Patient Advocate at this 14,000+ doctor medical conference.

Free Webinar: Stop Suffering – Learn How to Talk to Your Doctor for Better Health Outcomes http://drossmangastroenterology.com/free-webinar-stop-suffering-learn-talk-doctor-better-health-outcomes/ One of the greatest problems that emerges with continually decreasing amounts of time that clinicians can spend with patients include the inability to: 1) obtain sufficient high quality information about the illness and 2) have quality time to establish an effective patient-provider relationship. This can result in inaccurate diagnoses and treatments as well as patient and physician dissatisfaction with each other and the very process of care. This webinar is specifically designed for patients and features Douglas A. Drossman, MD, MACG, and one of his patients, Katie Errico, who recently published her health journey in The American Journal of Gastroenterology. Register here

IBcause™ Diagnostic Test IBcause helps doctors diagnose common underlying causes (the “troublemakers”) of persistent diarrhea, including gastrointestinal (GI) pathogens (eg, bacteria, viruses, and parasites), intestinal inflammation associated with inflammatory bowel disease (IBD), bile acid malabsorption, irritable bowel syndrome (IBS), and celiac disease. It analyzes a unique combination of 20 stool and blood measures all at 1 time. By combining so many different measures in 1 convenient test, IBcause may help speed up the step-by-step diagnostic process. It also helps your doctor determine if you have more than 1 issue that could be causing your persistent diarrhea, which is not uncommon. IBcause may help your doctor: Arrive at a diagnosis faster* Start you on the right treatment plan sooner With IBcause, over 90% of acute diarrhea-causing agents can be ruled out by your doctor. Link: >> https://www.ibcause.com ©2017 Prometheus Labs, Société des Produits Nestlé S.A. Vevey, Switzerland. All rights reserved. A Nestlé Health Science Company

Mistakes in irritable bowel syndrome and how to avoid them September 21, 2016 | By: Robin Spiller View complete version Around 11% of the worldwide population experience irritable bowel syndrome (IBS), making it one of the most frequent gastroenterological diagnoses.1 The symptoms of IBS include abdominal pain associated with unpredictable bowel habits and variable changes in the form and frequency of stool.2 While all patients with IBS suffer from recurrent bouts of abdominal pain, their bowel habits are varied: around one-third suffer predominantly with diarrhoea (IBS-D), one-fifth experience predominantly constipation (IBS-C) and half have an erratic mixed pattern of both diarrhoea and constipation (IBS-M).3This very heterogeneous condition undoubtedly has multiple causes and an individualized approach to management and treatment is required. Here I discuss the mistakes most frequently made when diagnosing and managing IBS. The mistakes and discussion that follow are based, where possible, on published data and failing that on many years of my own clinical experience. Mistake 1 | Failing to detect bile salt malabsorption Mistake 2 | Failing to recognize somatization, leading to multiple referrals to non-gastrointestinal specialists Mistake 3 | Not telling the patient that they have a high probability of having IBS at the onset of investigation Mistake 4 | Failing to recognize the key features of bloating, leading to multiple negative investigations including CT and ultrasound Mistake 5 | Using opiates to control IBS pain Mistake 6 | Misdiagnosing Crohn’s disease as IBS-D Mistake 7 | Performing cholecystectomy for right upper quadrant pain without gallstones Mistake 8 | Performing a hysterectomy/laparoscopy and division of adhesions for IBS pain Mistake 9 | Testing for lactose intolerance when a patient consumes <240ml of milk or its equivalent per day Mistake 10 | Encouraging food exclusion without reinforcing the need to reintroduce foods to confirm apparent intolerance, leading to ever more restricted diets and malnutrition © UEG 2016 Spiller. Reference: Spiller R. Mistakes in irritable bowel syndrome and how to avoid them. UEG Education 2016: 16; 31–33.