Functional bowel disorders with diarrhoea: Clinical guidelines of the United European Gastroenterology and European Society for Neurogastroenterology and Motility
| Autor: | Edoardo Savarino, Fabiana Zingone, Brigida Barberio, Giovanni Marasco, Filiz Akyuz, Hale Akpinar, Oana Barboi, Giorgia Bodini, Serhat Bor, Giuseppe Chiarioni, Gheorghe Cristian, Maura Corsetti, Antonio Di Sabatino, Anca Mirela Dimitriu, Vasile Drug, Dan L. Dumitrascu, Alexander C. Ford, Goran Hauser, Radislav Nakov, Nisha Patel, Daniel Pohl, Cătălin Sfarti, Jordi Serra, Magnus Simrén, Alina Suciu, Jan Tack, Murat Toruner, Julian Walters, Cesare Cremon, Giovanni Barbara |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Diarrhea
FDr IBS-D abdominal pain clinical practice guidelines diarrhea functional bowel disorders functional diarrhea irritable bowel syndrome Bile Acids and Salts Gastrointestinal Agents Humans Gastroenterology Irritable Bowel Syndrome INTESTINAL BACTERIAL OVERGROWTH GASTROINTESTINAL DISORDERS BILE-ACID MALABSORPTION DOUBLE-BLIND FECAL INCONTINENCE BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine GLUTEN-FREE DIET BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina Science & Technology Gastroenterology & Hepatology LACTOSE-MALABSORPTION CELIAC-DISEASE Oncology CAPSULE ENDOSCOPY ROME III Life Sciences & Biomedicine |
| Zdroj: | United European Gastroenterology Journal Volume 10 Issue 6 |
| ISSN: | 2050-6406 2050-6414 |
| Popis: | Irritable bowel syndrome with diarrhoea (IBS-D) and functional diarrhoea (FDr) are the two major functional bowel disorders characterized by diarrhoea. In spite of their high prevalence, IBS-D and FDr are associated with major uncertainties, especially regarding their optimal diagnostic work-up and management. A Delphi consensus was performed with experts from 10 European countries who conducted a literature summary and voting process on 31 statements. Quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation criteria. Consensus (defined as >80% agreement) was reached for all the statements. The panel agreed with the potential overlapping of IBS-D and FDr. In terms of diagnosis, the consensus supports a symptom-based approach also with the exclusion of alarm symptoms, recommending the evaluation of full blood count, C-reactive protein, serology for coeliac disease, and faecal calprotectin, and consideration of diagnosing bile acid diarrhoea. Colonoscopy with random biopsies in both the right and left colon is recommended in patients older than 50 years and in presence of alarm features. Regarding treatment, a strong consensus was achieved for the use of a diet low fermentable oligo-, di-, monosaccharides and polyols, gut-directed psychological therapies, rifaximin, loperamide, and eluxadoline. A weak or conditional recommendation was achieved for antispasmodics, probiotics, tryciclic antidepressants, bile acid sequestrants, 5-hydroxytryptamine-3 antagonists (i.e. alosetron, ondansetron, or ramosetron). A multinational group of European experts summarized the current state of consensus on the definition, diagnosis, and management of IBS-D and FDr. ispartof: UNITED EUROPEAN GASTROENTEROLOGY JOURNAL vol:10 issue:6 pages:556-584 ispartof: location:England status: published |
| Databáze: | OpenAIRE |
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