Modern aspects of the management of patients with irritable bowel syndrome
https://doi.org/10.21518/2079-701X-2021-5-22-28
Abstract
A review of modern data from the study of functional disorders of the digestive tract is performed. In the United States, 4 million people with functional bowel disorders seek medical care annually, and the annual cost of managing these patients is $ 358 million. Due to the urgency of the problem, new developments appear, among which it is necessary to highlight the American College of Gastroenterology (ACG) guidelines for the management of patients with IBS. To examine patients with suspected IBS, the authors of the ACG guideline proposed a positive diagnostic strategy, which is based on a careful study of the anamnesis, focusing on the key symptoms of the relationship between abdominal pain and bowel function during a long course of the disease (more than 6 months) and the absence of alarming symptoms with minimal use of instrumental diagnostic tests. For the diagnosis of IBS, the authors recommended serological testing for celiac disease, determination of fecal calprotectin and C-reactive protein to exclude inflammatory bowel diseases, but they did not consider it necessary to routinely analyze stool for intestinal pathogens. From our point of view, the absence of routine stool analysis for intestinal pathogens is completely inapplicable for Russia, since in our country the frequency of detection of diphyllobothriasis, giardiasis and opisthorchiasis is very high. The ACG consensus drew attention to the need to expand the evidence base for the use of some standard drugs for the treatment of IBS, proposed a number of new drugs (lebiprostone, linaclotide), recommended the use of rifaximin (for the treatment of IBS with a predominance of diarrhea) and tricyclic antidepressants (for the treatment of IBS). Analysis of modern international recommendations suggests that the clinical guidelines of the Russian Gastroenterological Association and the Association of Coloproctologists of Russia for the diagnosis and treatment of IBS are currently the main document governing the management of these patients in our country.
About the Authors
V. V. Tsukanov
Krasnoyarsk Science Centre of the Siberian Branch of Russian Academy of Science, Scientific Research Institute of Medical Problems of the North
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor, Head of the Clinical Department of the Digestive System Pathology of Adults and Children,
3g, Partizan Zheleznyak St., Krasnoyarsk, 660022
A. V. Vasyutin
Krasnoyarsk Science Centre of the Siberian Branch of Russian Academy of Science, Scientific Research Institute of Medical Problems of the North
Russian Federation
Russian Federation
Cand. Sci. (Med.), Senior Research fellow of the Clinical Department of the Digestive System Pathology of Adults and Children,
3g, Partizan Zheleznyak St., Krasnoyarsk, 660022
J. L. Tonkikh
Krasnoyarsk Science Centre of the Siberian Branch of Russian Academy of Science, Scientific Research Institute of Medical Problems of the North
Russian Federation
Russian Federation
Cand. Sci. (Med.), Leading Research Fellow of the Clinical Department of the Digestive System Pathology of Adults and Children,
3g, Partizan Zheleznyak St., Krasnoyarsk, 660022
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Review
For citations:
Tsukanov VV, Vasyutin AV, Tonkikh JL. Modern aspects of the management of patients with irritable bowel syndrome. Meditsinskiy sovet = Medical Council. 2021;(5):22-28. (In Russ.) https://doi.org/10.21518/2079-701X-2021-5-22-28
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