The DOI matches its Crossref record; 311 of the 311 references it cites were found in a registry or an index; 162 of the 282 sources its claims cite were checked for support.
British Society of Gastroenterology guidelines on the management of irritable bowel syndrome
Open accessAbstract
Irritable bowel syndrome (IBS) remains one of the most common gastrointestinal disorders seen by clinicians in both primary and secondary care. Since publication of the last British Society of Gastroenterology (BSG) guideline in 2007, substantial advances have been made in understanding its complex pathophysiology, resulting in its re-classification as a disorder of gut-brain interaction, rather than a functional gastrointestinal disorder. Moreover, there has been a considerable amount of new evidence published concerning the diagnosis, investigation and management of IBS. The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based management of patients. One of the strengths of this guideline is that the recommendations for treatment are based on evidence derived from a comprehensive search of the medical literature, which was used to inform an update of a series of trial-based and network meta-analyses assessing the efficacy of dietary, pharmacological and psychological therapies in treating IBS. Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system, summarising both the strength of the recommendations and the overall quality of evidence. Finally, this guideline identifies novel treatments that are in development, as well as highlighting areas of unmet need for future research.
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Claims the paper makes
73 Partly supported · 62 Supported · 47 No full text of the sources · 27 No basis given · 21 Own interpretation · 20 Sources not found · 10 Supported so far · 10 Own result · 9 Own method · 5 Couldn’t confirm · 4 Not checked yet · 2 Not supported · 1 Mixed support · accuracy not yet measured
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“The effect of FODMAP reintroduction to tolerance on IBS symptoms is therefore unclear, although there have been open-label studies reporting the long-term efficacy of an adapted low FODMAP diet ranges somewhere between 50% and 60%.177 203”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Disputedcites [177] sourceExperimental — accuracy not yet measured
The Introduction says evidence on reintroduction was previously unavailable, but this paper then studies it. Its Discussion reports that reintroduction to tolerance improved fiber intake without significant worsening of IBS symptoms; the Results report that reduced symptom severity was sustained at six months. Thus the paper does not present symptom outcomes after reintroduction as unclear. (LLM, conf=0.86)
Checked by a reasoning model — may be wrong.
- Not checked — no full text of the sourcecites [203] O"Keeffe, 2018, Long-Term impact of the low-FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability, and healthcare utilization in irritable bowel syndrome, Neurogastroenterol Motil source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“Linaclotide 290 μg once a day ranked first across all end points, including abdominal bloating (online supplemental figure 14-16 and online supplemental figure 19)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [154] sourceExperimental — accuracy not yet measured
The Results (p. 6) rank linaclotide 290 μg once daily first for the study’s efficacy endpoint, and the Discussion (p. 7) confirms that efficacy ranking. The Methods (p. 6) define that endpoint using abdominal pain and bowel movements; our copy does not report a ranking for abdominal bloating or establish that linaclotide ranked first across all endpoints. (LLM, conf=0.88)
- Disputedcites [155] sourceExperimental — accuracy not yet measured
The Discussion (p. 21) ranks linaclotide 290 μg once daily first for global symptoms, abdominal pain response, and complete spontaneous bowel movement response, but ranks tenapanor 50 mg twice daily first for bloating response. The Abstract (p. 7) makes the same distinction, contradicting the claim that linaclotide ranked first across all endpoints, including bloating. (LLM, conf=0.94)
Checked by a reasoning model — may be wrong.
plainn = 638- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Modulating activity of the brain regions responsible for visceral pain using various therapies has been shown to improve IBS symptomatology.[36][37][38]”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Central nervous system and autonomic nervous system modulation
What the sources say
- Partly supportedcites [36] sourceExperimental — accuracy not yet measured
The Background & Aims and Correlation of rCBF Changes and IBS Symptom Improvement sections report that alosetron improved IBS symptoms and that decreased activity in the amygdala, ventral striatum, and dorsal pons correlated with reduced abdominal pain. But the study tested one therapy and found reduced activity in central autonomic regions, not in areas activated by pain; it suggests rather than establishes that the brain changes caused the improvement. Page numbers were not available in our copy. (LLM, conf=0.88)
- Partly supportedcites [37] sourceExperimental — accuracy not yet measured
The Discussion reports that amitriptyline reduced pain-related brain activation during mental stress in patients with IBS, but describes symptom improvement through this mechanism as a postulate. The Symptom rating section found a nonsignificant preference for amitriptyline (p = 0.06) and a nonsignificant difference in pain ratings (p = 0.2). This single-drug study does not establish that various therapies improve IBS symptoms by modulating brain activity. (LLM, conf=0.88)
- Partly supportedcites [38] sourceExperimental — accuracy not yet measured
The Abstract and Conclusion report that cognitive therapy improved IBS symptoms alongside reduced activity in brain regions involved in pain perception. The paper studied one therapy and describes the neural changes as associated with improvement, not as proof that modulating those regions caused the improvement or that various therapies do so. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“This feature makes the Rome IV criteria potentially more specific than Rome III.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLASSIFICATION AND DIAGNOSTIC CRITERIA
What the sources say
- Partly supportedcites [9] sourceExperimental — accuracy not yet measured
In the IBS sensitivity analysis (page unavailable), the paper says Rome IV uses the more restrictive requirement of abdominal pain rather than Rome III’s abdominal pain or discomfort. It also estimates Rome IV specificity in a population survey, but the passages do not compare Rome IV and Rome III specificity, so they do not establish that Rome IV is more specific. (LLM, conf=0.78)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Some patients with IBS have compromised central inhibitory regulation of visceral and somatic stimuli.35”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Central nervous system and autonomic nervous system modulation
What the sources say
- Partly supportedcites [35] sourceExperimental — accuracy not yet measured
The Discussion concludes that IBS patients showed compromised inhibitory regulation of somatic pain stimuli. It also reports an earlier finding of impaired inhibition during visceral stimulation, but cautions that distraction, hypervigilance, or peripheral gut sensitization could explain that finding; this paper therefore does not establish compromised central inhibition of visceral stimuli. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Between 20% and 60% of patients with IBS have enhanced visceral perception to various physiological stimuli (eg, mechanical or electrical).41”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Altered visceral perception
What the sources say
- Partly supportedcites [41] sourceExperimental — accuracy not yet measured
The Introduction reports enhanced visceral perception in some IBS patients: 40–60% had lowered pain thresholds and 16–37% had increased sensory ratings to balloon distension. This supports the general point and a mechanical stimulus, but not the stated 20% lower bound across those measures or the example of electrical stimulation. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Altered activation of brain regions responsible for cognitive processing and emotional and autonomic responses to visceral and somatic stimuli are seen in IBS, consistent with visceral hypersensitivity, hypervigilance and symptom-related anxiety.34”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Central nervous system and autonomic nervous system modulation
What the sources say
- Partly supportedcites [34] Black CJ , Yiannakou Y , Houghton LA . Anxiety‐related factors associated with symptom severity in irritable bowel syndrome. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society 2020:e13872. sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Due to the uncertainty surrounding pooled estimates of global prevalence, and the apparent variation in prevalence between countries in separate studies, a subsequent Rome Foundation global survey has quantified the prevalence of IBS, among 73 000 adults in 33 different countries simultaneously, using both the Rome III and IV criteria.19”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > EPIDEMIOLOGY
What the sources say
- Partly supportedcites [19] sourceExperimental — accuracy not yet measured
The Methods and Results report a survey in 33 countries completed by 73,076 respondents, and the paper compares IBS prevalence under Rome III and Rome IV criteria. However, the FGID case definitions section says Rome III questions were included only in all nine household-survey countries and 14 of the 26 Internet-survey countries; the claim implies both criteria were used across the full survey. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Genetics, and epigenetic changes, infection and early adverse life events may predispose an individual to developing IBS, [25][26][27][28]”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > PATHOPHYSIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [25] source
- Partly supportedcites [26] sourceExperimental — accuracy not yet measured
The Abstract says family and twin studies suggest a genetic basis for IBS. The section “What in the Current State of Knowledge Is Lacking?” identifies infection and abuse as possible shared risk factors needing further study, but does not establish them as predisposing factors. No passage in our copy supports the claim about epigenetic changes. (LLM, conf=0.85)
- Not checked — no full text of the sourcecites [27] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“up to 50% of patients who believe they have IBS will no longer meet criteria for the condition.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > EPIDEMIOLOGY
What the sources say
- Partly supportedcites [21] sourceExperimental — accuracy not yet measured
The Introduction says Rome IV tightened the symptom requirements, and the Results report that some patients meeting Rome III did not meet Rome IV. But the paper does not report that up to 50% of patients who believe they have IBS lose eligibility; it studied a secondary-care referral population, not patients identified by that belief. (LLM, conf=0.84)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“This change reflected the findings of a normative survey showing that adopting a higher threshold for the frequency of abdominal pain required to meet criteria for IBS would lead to fewer healthy people in the general population being misclassified as having IBS, 9 and therefore risk being 'medicalised', and having to take drugs for the condition.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLASSIFICATION AND DIAGNOSTIC CRITERIA
What the sources say
- Supportedcites [9] source
In the frequency-threshold discussion (page not available in our copy), the authors say they used the 90th percentile of symptom frequency to limit misclassification of healthy people. They identify weekly abdominal pain as the recommended IBS threshold and contrast it with the lower Rome III threshold. The later claim about medicalisation and drug treatment is the citing authors’ inference, not a finding attributed to this source. (LLM, conf=0.91)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“chronic stress, psychological symptoms, negative beliefs about symptoms and illness and maladaptive coping mechanisms can increase the frequency and severity of symptoms.29 30”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > PATHOPHYSIOLOGY
What the sources say
- Partly supportedcites [29] sourceExperimental — accuracy not yet measured
The Environmental Influences section links chronic stress to exacerbation and intensity of IBS symptoms, while Psychological Distress says psychological symptoms can perpetuate or exacerbate FGID symptoms. The Psychological Treatments section discusses negative beliefs and avoidance as treatment targets, but does not clearly establish that maladaptive coping increases the frequency and severity of IBS symptoms. Page numbers were not provided in our copy. (LLM, conf=0.82)
- Partly supportedcites [30] sourceExperimental — accuracy not yet measured
The Cognitions & Metacognitions and Behaviours sections link negative illness-specific beliefs and some IBS-specific behaviours to symptom severity. But the Perceived Stress section reports that stress was not a significant treatment mediator, and the Discussion describes mixed findings for general psychological distress and behaviour. The paper does not establish that all the listed factors increase symptom frequency; page numbers are unavailable in our copy. (LLM, conf=0.87)
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, patients with normal transit can still have abnormal fasting and postprandial motility.48”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Transit and motility
What the sources say
- Supportedcites [48] source
The Discussion states that even patients with normal colonic transit frequently had reduced fasting and/or postprandial colonic tone. It also reports that 40% of patients with normal transit constipation had reduced tone in one or both conditions, supporting the claim that normal transit can coexist with abnormal motility. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“but the prevalence of abnormal serological testing for coeliac disease is almost three times higher in people with suspected IBS than people without symptoms of IBS, irrespective of predominant stool pattern.101”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigation in primary care
What the sources say
- Partly supportedcites [101] sourceExperimental — accuracy not yet measured
The Discussion (p. 17) reports that positive coeliac serology was up to three times more likely in people meeting IBS criteria. But it also says the increase was not consistent across IBS subtypes, so the claim’s “irrespective of predominant stool pattern” qualifier is not supported for serological testing. (LLM, conf=0.90)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Removal of the reacting antigen from the diet improved symptoms significantly.67”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
- Supportedcites [67] source
The Food Exclusion Diet and Follow-up Evaluation section (page unavailable) reports that 19 of 22 patients who reacted to food antigens had more than a 50% reduction in symptom score after four weeks on an individualized exclusion diet. The Discussion describes a marked benefit after removal of the identified food antigens. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, an integrated longitudinal multi-omics analysis of the gut microbiome, metabolome, host epigenome and transcriptome, in the context of host symptoms and physiology in patients with IBS-D and IBS-C, identified subtype-specific and symptom-related variations in microbial composition and function.76”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > The microbiome
What the sources say
- Supportedcites [76] source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Strong evidence supports a role for bacterial, viral or parasitic infections triggering IBS.51”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > The microbiome
What the sources say
- Supportedcites [51] source
The Introduction states that bacterial, viral and protozoal enteritis have all been associated with post-infectious IBS. The Discussion reports increased IBS risk after infectious enteritis, while noting that the risk following viral enteritis is lower and shorter-lived than after bacterial or protozoal enteritis. (LLM, conf=0.93)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Reports from patients with IBS confirm that they would like increased empathy, support and information about the nature of the condition from general practitioners, and options for symptom management.87”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Doctor-patient communication and patient perspectives in primary care
What the sources say
- Supportedcites [87] source
The Results (Themes 1 and 2) report patients’ concerns about inadequate explanations of IBS, limited advice, and a lack of empathy and support from GPs. The Results also describe participants’ interest in information about management options, including earlier access to CBT. The study concerns patients with refractory IBS. (LLM, conf=0.91)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“With regard to fibre, a systematic review and meta-analysis of 15 RCTs, comprising 946 patients, demonstrated its benefit in IBS (RR of symptoms persisting=0.87;95% CI 0.80 to 0.94) (online supplemental figure 1).158”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Could not verifycites [158] sourceExperimental — accuracy not yet measured
The Abstract (page not available) identifies this as a review of prebiotics, probiotics, synbiotics and antibiotics. The 'Efficacy and Safety of Prebiotics in IBS' section (page not available) describes three eligible prebiotic RCTs, not a 15-trial fibre analysis. Searches for fibre, 946 patients and the stated risk estimate found no passage in our copy reporting the claimed result. (LLM, conf=0.75)
boosteddirectn = 946- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
Every source the paper cites for this claim was checked and supports it.
In the paper
“Most patients with IBS are diagnosed and managed by general practitioners in community settings and are never referred to secondary care, even if they have ongoing troublesome symptoms.82”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > When to refer patients to secondary care
What the sources say
- Supportedcites [82] source
The Discussion states that GPs manage most patients with IBS wholly in primary care, and the referral analysis reports that only 29% were referred during the study period. The Discussion table also reports symptoms lasting more than six months in 72% of patients and interference with social life in 63%, supporting the point that symptoms could persist or be troublesome without referral. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In a primary care study of patients with refractory IBS, only 10% had ever had a secondary care referral.86”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > When to refer patients to secondary care
What the sources say
- Partly supportedcites [86] sourceExperimental — accuracy not yet measured
Table 1 (Results > Baseline characteristics; page unavailable) reports that 57 of 558 participants (10.2%) had seen a GI consultant for IBS. The Methods (Study design and participants; page unavailable) say participants were recruited from both primary-care practices and secondary-care clinics. The paper therefore supports the approximate 10% figure, but not its restriction to primary-care patients or the wording that they had received a referral. (LLM, conf=0.87)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The update to the prior systematic review and meta-analysis, 161 used to inform this guideline, identified 11 trials comparing a low FODMAP diet with various dietary control interventions, including habitual diet, a high FODMAP diet, traditional dietary advice as recommended by NICE and the BDA or a sham diet, in 658 participants.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Supportedcites [161] source
The citation identifies the prior systematic review and meta-analysis being updated, and this source is that review. Its Table 2 (p. 8) summarizes low-FODMAP trials; the sentence presents the 11-trial, 658-participant count as a result of the later update, not of this source. (LLM, conf=0.87)
plainn = 658- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A validation study of the Rome IV criteria in secondary care demonstrated this was particularly the case for IBS-C and IBS-M.21”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigations in secondary care
What the sources say
- Supportedcites [21] source
The Abstract reports that this secondary-care validation study found the Rome IV criteria performed best in patients with IBS with constipation or mixed bowel habits. These correspond to IBS-C and IBS-M, supporting the cited statement. (LLM, conf=0.93)
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“despite this being the rationale for use of nonabsorbable antibiotics in IBS, 70 a positive breath test result does not predict response to treatment.145”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigations in secondary care
What the sources say
- Could not verifycites [70] sourceExperimental — accuracy not yet measured
The Discussion (page not available) says that response to antibiotic therapy has been shown to correlate with normalization of lactulose hydrogen breath tests. That concerns a change in test results, not whether a positive test before treatment predicts response. A search for baseline breath-test results and treatment-response prediction found no passage addressing the claim. (LLM, conf=0.73)
- Not checked — no full text of the sourcecites [145] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Soluble fibre, such as ispaghula, is an effective treatment for global symptoms and abdominal pain in IBS, but insoluble fibre (eg, wheat bran) should be avoided as it may exacerbate symptoms.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Could not verifycites [158] sourceExperimental — accuracy not yet measured
The ‘Efficacy and Safety of Prebiotics in IBS’ section discusses oligosaccharide trials, not insoluble fibre or wheat bran. Searches for wheat bran, insoluble fibre, and ispaghula found no passage in our copy addressing whether bran exacerbates IBS symptoms or should be avoided. Page numbers were not available. (LLM, conf=0.76)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The effect of FODMAP reintroduction to tolerance on IBS symptoms is therefore unclear, although there have been open-label studies reporting the long-term efficacy of an adapted low FODMAP diet ranges somewhere between 50% and 60%.177 203”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Partly supportedcites [177] sourceExperimental — accuracy not yet measured
The Results (Effect on symptom severity; page unavailable) report that symptom improvement was sustained at six months after Group I began reintroducing FODMAPs to tolerance. The Methods (Study protocol; page unavailable) describe an unblinded study, but the paper does not report a 50%–60% long-term efficacy rate; its Background instead mentions approximately 70% effectiveness for a low-FODMAP diet without specifying long-term adapted-diet outcomes. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [203] O"Keeffe, 2018, Long-Term impact of the low-FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability, and healthcare utilization in irritable bowel syndrome, Neurogastroenterol Motil source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Moreover, a low FODMAP diet may induce detrimental changes to the gut microbiota, with reductions in Bifidobacteria and total bacterial count, 212 although the long-term consequences of this are unknown.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Supportedcites [212] source
The Gut microbiota section reports a prior low-FODMAP study that found reduced Bifidobacteria and describes this as potentially unfavourable. The Discussion reports that this paper’s low-FODMAP diet reduced total faecal bacterial abundance; its conclusion says the longer-term health implications remain uncertain. (LLM, conf=0.90)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Despite significant heterogeneity between trials, presumably driven by differences in antispasmodics studied, patient selection and study design, fewer patients treated with antispasmodics had persistent global symptoms or abdominal pain (RR 0.65; 95% CI 0.56 to 0.76) (online supple- mental figure 4).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [160] source
The Antispasmodics section reports that fewer patients receiving antispasmodics had IBS symptoms that did not improve, with the exact RR and confidence interval cited. It also reports significant heterogeneity between trials. The source describes the outcome as IBS symptom improvement rather than using the citing sentence’s wording of persistent global symptoms or abdominal pain. (LLM, conf=0.92)
plaindirectn = 2,811- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Moreover, a low FODMAP diet may induce detrimental changes to the gut microbiota, with reductions in Bifidobacteria and total bacterial count, 212 although the long-term consequences of this are unknown.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Supportedcites [212] source
The Abstract says the implications of long-term FODMAP restriction require elucidation. The Discussion likewise treats the health implications of the observed microbiota changes as uncertain and advises caution about longer-term restriction. (LLM, conf=0.93)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A prior systematic review identified only 2 RCTs of loperamide in IBS-D and IBS-M containing 42 patients.160”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [160] source
The “9. Loperamide” section reports that the review included two loperamide trials involving 42 patients. It specifies that one trial recruited patients with IBS-M and the other patients with IBS-D. No page number is provided in our copy. (LLM, conf=0.93)
plainn = 42- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Finally, some patients with IBS report symptomatic benefit from a gluten-free diet despite no objective evidence of coeliac disease.204”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Supportedcites [204] source
The Manuscript (p. 5) says that up to 25% of patients with IBS report non-celiac wheat sensitivity and that a subset shows clinical improvement following a gluten-free diet. The same passage describes excluding celiac disease when evaluating these patients. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, as reported in the prior meta-analysis, 161 the quality of evidence from these trials was very low, due to small sample sizes, difficulties in blinding and heterogeneity between studies.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Partly supportedcites [161] sourceExperimental — accuracy not yet measured
Table 2 (p. 8) rates the overall low-FODMAP trial evidence VERY LOW and records serious risk of bias and very serious imprecision; the trial summaries (p. 6) also describe patients who were not blinded. But Table 2 rates inconsistency as “not serious,” so it does not support heterogeneity between studies as a reason for the very-low rating. Some outcomes in the same table are rated LOW rather than VERY LOW. (LLM, conf=0.88)
plaindirectn = 658- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A low FODMAP diet was associated with a reduction in the risk of remaining symptomatic, compared with all control interventions (RR 0.71; 95% CI 0.61 to 0.83) (online supplemental figure 2).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Partly supportedcites [161] sourceExperimental — accuracy not yet measured
Table 2 (p. 8) supports a lower risk of persistent IBS symptoms with a low-FODMAP diet versus control diets. Its pooled estimate for seven trials is RR 0.69 (95% CI 0.54–0.88), not the claimed RR 0.71 (95% CI 0.61–0.83). (LLM, conf=0.90)
plaincorrelationaln = 658- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The faecal microbiome of patients with IBS may differ significantly from that of healthy individuals.216”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Probiotics
What the sources say
- Supportedcites [216] source
The Discussion reports differences in fecal microbiota between patients with IBS and healthy controls, including differences in Firmicutes-related sequences and significantly different counts of an Actinobacteria species. This supports the citing sentence’s hedged claim. (LLM, conf=0.94)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A prior meta-analysis identified 26 RCTs, containing 2811 patients, which compared 13 different antispasmodics with placebo.160”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [160] source
The Antispasmodics section reports an analysis of 26 RCTs involving 2,811 patients and evaluating 13 antispasmodics. Its results compare antispasmodic therapy with placebo, matching the cited claim. (LLM, conf=0.93)
plainn = 2,811- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The incidence of adverse events with loperamide was similar to placebo in these trials.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [160] source
The “9. Loperamide” section reports adverse-event totals for both loperamide trials: neither arm had any events in one trial, and each arm had four in the other. This supports the claim that adverse-event incidence was similar to placebo in these trials. (LLM, conf=0.94)
plainn = 42- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In an update of a previous meta-analysis, 155 a dose of 290 μg once a day linaclotide was superior to placebo in 5 RCTs, containing 3193 patients, for the FDA composite end point for IBS-C, consisting of improvement in abdominal pain and an increase of ≥1 CSBMs per week from baseline (RR 0.82; 95% CI 0.78 to 0.87) (online supplemental figure 14), abdominal pain alone (online supplemental figure 15”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
The Efficacy section (p. 16) supports that linaclotide 290 μg once daily was more effective than placebo on the FDA-recommended IBS-C endpoint. It reports three linaclotide RCTs and an RR of 0.81 (95% CI 0.76–0.86), not five RCTs and an RR of 0.82 (95% CI 0.78–0.87); it does not give 3,193 patients for that comparison. (LLM, conf=0.92)
plaindirectn = 3,193- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“abdominal pain alone (online supplemental figure 15)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Supportedcites [155] source
The Discussion (p. 21) ranks linaclotide 290 μg once daily first for abdominal pain response, and Supplementary Table 4 (p. 48) presents the abdominal-pain-response comparison. The paper also reports that linaclotide was superior to placebo in IBS-C. (LLM, conf=0.88)
plaindirectn = 3,193- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A small crossover trial of ondansetron titrated from 4 mg once a day to a maximum of 8 mg three times a day demonstrated significantly higher rates of improvement in urgency, bloating and stool consistency, but not abdominal pain.236”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Supportedcites [236] source
The Abstract Methods and Intervention sections describe a crossover trial starting at 4 mg once daily, with titration to two 4 mg capsules three times daily. The Abstract Results report significant improvements versus placebo in urgency, bloating, and stool consistency, but no significant change in pain scores. (LLM, conf=0.93)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“For, abdominal pain, ramosetron 2.5μg once a day and ramosetron 5 μg once a day were ranked first and second, respectively (online supplemental figure 13).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [153] sourceExperimental — accuracy not yet measured
The ‘Failure to achieve an abdominal pain response’ section (page unavailable) ranks ramosetron 2.5 µg once daily first and reports that ramosetron 5 µg once daily was more effective than placebo. It does not state that the 5 µg dose ranked second for abdominal pain. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Adverse events were no more common with lubiprostone, except for nausea.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Supportedcites [155] source
Supplementary Table 7 (p. 52) shows no statistically significant increase in overall adverse events with lubiprostone 8 mcg twice daily versus placebo (RR 1.20; 95% CI 0.98–1.48). The safety results (p. 20) report that nausea was significantly more common with lubiprostone. (LLM, conf=0.90)
plainn = 452- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“For the FDA composite end point, alosetron was superior to all treatments, except ramosetron 2.5 μg once a day”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Supportedcites [153] source
The Results passage on the FDA-recommended composite endpoint reports significant differences favouring alosetron 1 mg twice daily over every other active treatment except ramosetron 2.5 µg once daily. The citing sentence omits the alosetron dose but otherwise matches the finding. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“RR 0.87; 95% CI 0.81 to 0.93 for 6 μg once a day in 2 RCTs, containing 1461 patients) (online supplemental figure 14)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirectn = 1,461- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The drug was superior to placebo for abdominal bloating in these 2 RCTs (online supplemental figure 17).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Supportedcites [155] source
The bloating-response analysis (p. 18) says lubiprostone was more effective than placebo and identifies its data as a post hoc analysis of two phase III RCTs. Supplementary Table 6 (p. 51) reports a relative risk of 0.85 (95% CI 0.75–0.96) for failure to achieve a bloating response versus placebo. (LLM, conf=0.90)
plaindirectn = 452- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The drug was also superior to placebo in terms of an improve- ment in abdominal bloating in 4 trials containing 3061 patients (online supplemental figure 17).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
The bloating-response results (p. 18) report that linaclotide 290 μg once daily was more effective than placebo. However, that result came from two linaclotide trials; the entire bloating-response analysis comprised five trials and 2,257 patients, not four trials and 3,061 patients. (LLM, conf=0.91)
plaindirectn = 3,061- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Eluxadoline 100 mg two times per day was also superior to placebo for abdominal pain (online supplemental figure 13).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Supportedcites [153] source
The ‘Failure to achieve an abdominal pain response’ section states that eluxadoline 100 mg twice daily was significantly more effective than placebo. This directly supports the claim about abdominal pain. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Serious adverse events, including pancreatitis and sphincter of Oddi spasm, have been reported, occurring in 0.5% of patients in these trials. 230”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [230] sourceExperimental — accuracy not yet measured
The Results sections on pancreatitis and sphincter of Oddi spasm (SOS; page unavailable) report both events in eluxadoline-treated patients. But 0.5% is the rate of SOS events, not serious adverse events overall: the Serious AEs section reports rates of 4.2% and 4.0% in the two eluxadoline groups, while pancreatitis occurred in 0.4% overall. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“an increase of ≥1 CSBMs per week from baseline (online supplemental figure 16)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Supportedcites [155] source
Data Extraction (p. 12) defines a CSBM responder as having at least one more CSBM per week than at baseline for at least 50% of weeks. The Failure to Achieve a CSBM Response results (p. 18) report that linaclotide 290 μg once daily was significantly more effective than placebo on this endpoint. (LLM, conf=0.94)
plaindirectn = 3,193- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Again, the drug was more likely to improve abdominal bloating than placebo in 3 trials containing 1428 patients (online supplemental figure 17).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
The Failure to Achieve a Bloating Response section (p. 18) reports that tenapanor 50 mg twice daily was more effective than placebo, but its bloating result came from one RCT, not three, and the confidence interval was wide and touched 1. The five RCTs reporting bloating-response data across the drugs included 2,257 patients; this copy does not support the claimed 1,428 patients. (LLM, conf=0.90)
plaindirectn = 1,428- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A network meta-analysis examining the relative efficacy of secretagogues and tegaserod across 18 RCTs, in 10 638 patients, demonstrated that all drugs were superior to placebo.154 155”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [154] sourceExperimental — accuracy not yet measured
The Results (p. 6) report that all treatments were significantly more effective than placebo, and the Methods (p. 5) confirm that the network meta-analysis added tegaserod trials. But the Results specify 14 trials and 9,113 patients for the efficacy endpoint, not the claimed 18 RCTs and 10,638 patients. (LLM, conf=0.90)
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
The Results (p. 15) report 15 trials with 8,462 patients, not 18 trials with 10,638. The Discussion (p. 21) says all secretagogues tested were more effective than placebo for global IBS-C symptoms, but the eligibility criteria (p. 10) do not include tegaserod. The cited paper therefore supports the placebo comparison for secretagogues, not the claim as a whole. (LLM, conf=0.90)
boosteddirectn = 10,638- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Indeed, a meta-analysis of RCTs has shown that gut-directed hypnotherapy is one of the few treatments that performs better than a control for patients with refractory symptoms (online supple- mental figure 21).156”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [156] source
The Discussion states that, among patients with refractory symptoms, only group CBT and gut-directed hypnotherapy were more efficacious than both control interventions studied: education and/or support and routine care. The Abstract reports the same finding for the trials recruiting only patients with refractory symptoms. (LLM, conf=0.94)
plaindirectn = 639- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Key mechanisms related to reduction in IBS symptom severity appear to be changes in IBS-specific cognitions and gastrointestinal -specific anxiety, rather than changes in general anxiety.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [30] source
The Abstract identifies changes in illness-specific cognitions as a key process and says gastrointestinal-specific anxiety may also be a key mechanism, whereas general or state anxiety does not appear to be. The section ‘Gastrointestinal Specific Anxiety Versus General Anxiety’ likewise contrasts gastrointestinal-specific with general anxiety. (LLM, conf=0.94)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“and abdominal pain alone (online supplemental figure 15), but not for an increase of ≥1 CSBMs per week from baseline (online supplemental figure 16).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
The Results section (p. 17) says all treatments except linaclotide 250 μg once daily were significantly more effective than placebo for abdominal-pain response, which includes plecanatide. But the paper lists the plecanatide doses as 3 mg and 6 mg once daily (Supplementary Table 4, p. 48), not 3 μg and 6 μg. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“self-administered or minimal contact CBT (4 trials, 434 patients, RR 0.61; 95% CI 0.45 to 0.83)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Partly supportedcites [156] sourceExperimental — accuracy not yet measured
The ‘Efficacy at First Point of Follow-up Post-treatment’ section reports RR 0.61 (95% CI 0.45 to 0.83) for self-administered or minimal-contact CBT and says it was more efficacious than all four control interventions, including waiting-list control. The passages in our copy do not substantiate the claimed four trials or 434 patients for this treatment. (LLM, conf=0.85)
plaindirectn = 434- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The network meta-analysis also demonstrated that therapist-delivered CBT over the telephone, web-based CBT, face-to-face CBT and self-administered or minimal contact CBT were all superior to treatment as usual after 12 months of follow-up (online supplemental figure 22).156”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Partly supportedcites [156] sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) says that telephone-delivered CBT was superior to routine care at 12 months. It identifies internet and self-administered or minimal-contact CBT as having longer-term efficacy, but does not establish that they—or face-to-face CBT—were each superior to routine care at 12 months. The reported face-to-face comparison is at the first post-treatment follow-up, not 12 months. (LLM, conf=0.88)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Gut-directed hypnotherapy is one of the psychological therapies for IBS with the largest evidence base for both short-term and long-term efficacy in RCTs.156”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [156] source
The Discussion identifies gut-directed hypnotherapy as one of the therapies with the largest numbers of RCTs and patients showing efficacy for IBS symptoms, and says it was among the most efficacious long-term. The 'What are the new findings' section likewise reports substantial evidence for efficacy and evidence of longer-term efficacy, while noting that all trials were at high risk of bias. (LLM, conf=0.92)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“but not for an increase of ≥1 CSBMs per week from baseline (online supplemental figure 16).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
The Data Extraction section (p. 12) defines a CSBM responder as having an increase of at least one CSBM per week from baseline for at least half the weeks, and the study table (p. 36) lists plecanatide once-daily arms. But those doses are 3 mg and 6 mg, not the claimed 3 μg and 6 μg. The retrieved CSBM-response passages do not establish whether either dose was superior to placebo on that outcome. (LLM, conf=0.72)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“A recent network meta-analysis of RCTs of psychological therapies for IBS demonstrated that several psychological therapies were more efficacious than control interventions.156”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [156] source
The Discussion states that the systematic review and network meta-analysis found several psychological therapies more efficacious than a control intervention for IBS symptoms. The Efficacy at First Point of Follow-up Post-treatment section also identifies therapies that outperformed particular control interventions. (LLM, conf=0.95)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“However, in the ACTIB trial, health economic analysis suggested web-based CBT was the more cost-effective option.244”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Could not verifycites [244] sourceExperimental — accuracy not yet measured
The Overview of economic evaluation and Health economic assessment sections compare faecal immunochemical testing with colonoscopy for post-polypectomy surveillance, not CBT treatments. Searches for ACTIB and web-based or cognitive behavioural therapy found no passage addressing the claimed cost-effectiveness finding. (LLM, conf=0.78)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Finally, tegaserod was superior to placebo for abdominal bloating in 4 RCTs, containing 5132 patients (online supplemental figure 17).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [154] sourceExperimental — accuracy not yet measured
The Results (p. 6) report that tegaserod was more effective than placebo on a combined IBS-C treatment-response endpoint, not specifically on abdominal bloating. The Methods (p. 5) describe three tegaserod RCTs containing 2,472 patients, rather than four RCTs containing 5,132 patients. (LLM, conf=0.85)
plaindirectn = 5,132- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“and clinical outcomes in children and adolescents with IBS suggest that use of gut-directed hypnotherapy at an earlier stage of the condition may be beneficial.253”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [253] Vasant, 2020, Gut-focused hypnotherapy for children and adolescents with irritable bowel syndrome, Frontline Gastroenterol source
The Discussion reports improved IBS symptoms after gut-focused hypnotherapy in children and adolescents and says the findings support considering it at an earlier stage than in adults. The clinical-practice summary makes the same recommendation, while framing its longer-term benefit as a possibility. (LLM, conf=0.94)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The network meta-analysis suggested that therapist-delivered CBT over the telephone had a larger effect on IBS symptoms at follow-up than web-based CBT.156”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [156] source
The Discussion (page not available in our copy) says both telephone and internet CBT had evidence of longer-term efficacy, and telephone CBT ranked first at 12 months. That supports the hedged claim of a larger estimated effect at follow-up, though the paper does not establish a statistically significant difference between the two therapies. (LLM, conf=0.88)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The drug was also more efficacious than placebo for abdominal pain (online supplemental figure 15)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
The abstract (p. 7) reports that tenapanor was superior to placebo for IBS-C overall, and Supplementary Table 4 (p. 48) includes tenapanor 50 mg twice daily in the abdominal-pain-response analysis. The passages available here do not show its abdominal-pain comparison with placebo, so they do not establish the specific outcome claimed. (LLM, conf=0.69)
plaindirectn = 1,428- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“but on indirect comparison of active treatments there were no significant differences between individual drugs and dosages.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Supportedcites [154] source
The Results (p. 6) state this directly for the indirect comparison of active treatments. The Discussion (p. 7) likewise says that none of the drugs was superior to another. (LLM, conf=0.95)
- Supportedcites [155] source
The Efficacy results (p. 16) explicitly report no significant differences between individual drugs and dosages in indirect comparisons of active treatments. The paper reports the same finding for other efficacy endpoints (pp. 17–18). (LLM, conf=0.95)
plainn = 638- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In a meta-analysis using data from these 3 trials, containing 2472 patients, the drug was superior to placebo (RR 0.85; 95% CI 0.80 to 0.91) (online supplemental figure 14).154”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Supportedcites [154] source
The Methods (p. 5) describe three tegaserod trials involving 2,472 female patients with IBS-C. The Results (p. 6) report that tegaserod was significantly more effective than placebo, with RR 0.85 (95% CI 0.80–0.91). (LLM, conf=0.94)
plaindirectn = 2,472- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In a large, multicentre, RCT in patients with IBS in primary or secondary care, group hypnotherapy was shown to be non-inferior to individual hypnotherapy.258”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [258] source
The indexed paper describes a multicentre randomised trial of 354 patients with IBS referred from primary or secondary care (Abstract, page unavailable). Its findings state that group hypnotherapy was non-inferior to individual hypnotherapy in the per-protocol analysis. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The network meta-analysis of psychological interventions for IBS, which included 15 trials of CBT in 1844 patients, concluded that CBT delivered in several formats was more effective than a control, including education and support, treatment as usual, and a waiting list control (online supplemental figure 20).156”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Partly supportedcites [156] sourceExperimental — accuracy not yet measured
The Discussion and the section ‘Efficacy at First Point of Follow-up Post-treatment’ report that several CBT formats were more effective than control interventions for IBS. Our copy does not substantiate the specific count of 15 CBT trials and 1844 patients; the Results give 41 trials and 4072 participants for all psychological therapies combined. The comparison also depends on format: group CBT was not more effective than education and/or support. (LLM, conf=0.85)
plaindirectn = 1,844- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“group CBT (2 trials, 50 patients, RR 0.41; 95% CI 0.19 to 0.91)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Partly supportedcites [156] sourceExperimental — accuracy not yet measured
The ‘Efficacy at First Point of Follow-up Post-treatment’ section says group CBT was more efficacious than waiting-list control and was assessed in two small trials. However, our copy does not establish the stated total of 50 patients, and Table 2 reports a nearby but different estimate, RR 0.40 (95% CI 0.18–0.90), rather than 0.41 (0.19–0.91). Page numbers are not available in the indexed passages. (LLM, conf=0.87)
plaindirectn = 50- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Except for diarrhoea, adverse events were no more likely with the drug than with placebo.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Supportedcites [155] source
The Safety results (p. 19) do not identify tenapanor as significantly increasing overall adverse events versus placebo; Supplementary Table 7 (p. 52) gives a relative risk of 1.20 with a 95% CI of 0.87–1.64. The individual-event results (p. 20) report increased diarrhoea risk with tenapanor, but no significant increase versus placebo in abdominal pain, abdominal distension, headache, or nausea. Thus, “no more likely” is supported as a statement about statistically significant differences in the adverse events assessed. (LLM, conf=0.90)
plainn = 1,428- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Face-face CBT (10 RCTs, 930 patients, RR 0.62; 95% CI 0.48 to 0.80)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Partly supportedcites [156] sourceExperimental — accuracy not yet measured
The ‘Efficacy at First Point of Follow-up Post-treatment’ section reports face-to-face CBT at RR 0.62 (95% CI 0.48 to 0.80) and says it was more efficacious than all four control interventions, including waiting-list control. Our copy does not establish the attributed counts of 10 RCTs and 930 patients; the reported RR is a network-meta-analysis estimate, not specifically a waiting-list comparison. (LLM, conf=0.88)
plaindirectn = 930- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“therapistdelivered CBT over the telephone (1 RCT, 373 patients, RR 0.50; 95% CI 0.29 to 0.84)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Partly supportedcites [156] sourceExperimental — accuracy not yet measured
The Efficacy at First Point of Follow-up Post-treatment section says CBT via telephone was more efficacious than waiting-list control and was represented by one trial. It reports 558 patients for that trial, not 373; the cited RR of 0.50 (95% CI 0.29–0.84) is not substantiated by the passages found in our copy. No page number is available in the indexed text. (LLM, conf=0.87)
plaindirectn = 373- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, the most compelling evidence, based on the number of trials and long-term outcomes was for CBT and gut-directed hypnotherapy, 156”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [156] source
The Discussion states that CBT-based interventions and gut-directed hypnotherapy had the largest evidence base and were the most efficacious long-term. It also identifies CBT and gut-directed hypnotherapy among the interventions with the largest numbers of trials and patients. Page numbers are not available in the supplied passages. (LLM, conf=0.94)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, its clinical efficacy has also been demonstrated in non-refractory populations, 156”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Partly supportedcites [156] sourceExperimental — accuracy not yet measured
The Results section ('Efficacy at First Point of Follow-up Post-treatment'; page not provided) reports efficacy for gut-directed hypnotherapy across the pooled IBS trials. It separately analyzes trials limited to refractory IBS, but does not establish efficacy specifically in non-refractory patients. The Discussion calls for trials earlier in the disease course. (LLM, conf=0.85)
boosteddirectn = 639- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“For patients with symptoms that are refractory to these pharmacological therapies, and those who have comorbid conditions or psychological symptoms, a combination of a gutbrain neuromodulator and psychological therapy may be more efficacious than monotherapy with either, drawing parallels with evidence from the depression and chronic headache literature.288 289”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Guidelines
What the sources say
- Not checked — no full text of the sourcecites [288] source
- Partly supportedcites [289] sourceExperimental — accuracy not yet measured
The Abstract and COMMENT report that, in adults with chronic tension-type headache, tricyclic medication plus stress-management therapy produced clinically significant headache reductions more often than either treatment alone, though other outcomes were similar. The Participants and COMMENT sections do not establish this advantage for patients refractory to medication or those with comorbid conditions or psychological symptoms; the trial excluded several comorbid conditions. No page numbers are provided in our copy. (LLM, conf=0.88)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“in a small RCT in 45 patients the histamine 1 receptor antagonist ebastine led to significant improvements in both abdominal pain and global symptoms.290”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs in development
What the sources say
- Partly supportedcites [290] sourceExperimental — accuracy not yet measured
The trial-results section reports significantly greater global symptom relief and lower abdominal pain scores with ebastine than with placebo at week 12. The stated trial size is incorrect: 55 patients were randomized, not 45 (51 completed treatment). No page number is available in our copy. (LLM, conf=0.92)
plaindirectn = 45- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Unfortunately, a meta-analysis of 5 RCTs, containing 267 patients, demonstrated no significant benefit of FMT compared with placebo (RR 0.98; 95% CI 0. 58 to 1.66)”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Other treatments in development
What the sources say
- Supportedcites [294] source
The Efficacy of FMT in IBS section (p. 11) reports pooled results from five trials: 158 patients assigned to FMT and 109 to placebo, totaling 267. It gives an RR of 0.98 (95% CI 0.58 to 1.66) for IBS symptoms not improving; the Discussion (p. 14) states that the pooled analysis found no significant improvement with FMT versus placebo. (LLM, conf=0.95)
boostedn = 267- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“and in 2 pooled trials placebo capsules administered orally were superior to capsules containing donor stool (RR 1.96; 95% CI 1.19 to 3.20).294”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Other treatments in development
What the sources say
- Supportedcites [294] source
The Summary (p. 4) states that orally administered placebo capsules were superior to donor-stool capsules in two pooled trials, with RR 1.96 (95% CI 1.19–3.20). The Efficacy of FMT in IBS section (pp. 11–12) reports the same subgroup result. (LLM, conf=0.95)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The highly selective 5-HT 4 agonist minesapride has been studied in 2 phase II dose-ranging RCTs in patients with IBS-C.179 180 A dose of 40 mg once a day was superior to placebo, in terms of improvements in number of bowel movements per week, abdominal pain and global symptoms.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs in development
What the sources say
- Not checked — no full text of the sourcecites [179] source
- Partly supportedcites [180] sourceExperimental — accuracy not yet measured
The Results > Efficacy section reports that 40 mg minesapride improved spontaneous bowel movement frequency versus placebo, but found no significant difference in abdominal pain or global symptom measures at Week 12. The Introduction describes improvements in abdominal and overall IBS symptoms in an earlier phase 2 study; it does not make those outcomes significant findings of both trials. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Linaclotide, a guanylate cyclase-C agonist, is an efficacious second-line drug for IBS with constipation in secondary care.”
- Also stated in: § Recommendations · plain
“Linaclotide, a guanylate cyclase-C agonist, is an efficacious second-line drug for IBS with constipation in secondary care.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Recommendations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Recommendations · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Eluxadoline, a mixed opioid receptor drug, is an efficacious second-line drug for IBS with diarrhoea in secondary care.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There is good evidence that psychological treatments directed against IBS symptoms, especially cognitive behavioural therapy (CBT), and hypnotherapy, are helpful for many patients' symptoms, but unfortunately these are not always readily accessible.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Patient summary
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Probiotics, as a group, may be an effective treatment for global symptoms and abdominal pain in IBS, but it is not possible to recommend a specific species or strain.”
- Also stated in: § Recommendations · hedged
“Probiotics, as a group, may be an effective treatment for global symptoms and abdominal pain in IBS, but it is not possible to recommend a specific species or strain.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > First-line treatments
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Recommendations · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Tenapanor, a sodium-hydrogen exchange inhibitor, is an efficacious second-line drug for IBS with constipation in secondary care.”
- Also stated in: § Recommendations · plain
“Tenapanor, a sodium-hydrogen exchange inhibitor, is an efficacious second-line drug for IBS with constipation in secondary care.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Recommendations · plain
None of the sources cited for this claim have been checked yet.
In the paper
“IBS-specific cognitive behavioural therapy may be an efficacious treatment for global symptoms in IBS (recommendation: strong, quality of evidence: low).”
- Also stated in: § Recommendations · hedged
“IBS-specific cognitive behavioural therapy may be an efficacious treatment for global symptoms in IBS (recommendation: strong, quality of evidence: low).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Recommendations · hedged
None of the sources cited for this claim have been checked yet.
In the paper
“Soluble fibre, such as ispaghula, is an effective treatment for global symptoms and abdominal pain in IBS, but insoluble fibre (eg, wheat bran) should be avoided as it may exacerbate symptoms.”
- Also stated in: § Fibre and dietary therapies · plain
“Soluble fibre, such as ispaghula, is an effective treatment for global symptoms and abdominal pain in IBS, but insoluble fibre (eg, wheat bran) should be avoided as it may exacerbate symptoms.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > First-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Fibre and dietary therapies · plain
None of the sources cited for this claim have been checked yet.
In the paper
“Lubiprostone, a chloride channel activator, is an efficacious second-line drug for IBS with constipation in secondary care.”
- Also stated in: § Recommendations · plain
“Lubiprostone, a chloride channel activator, is an efficacious second-line drug for IBS with constipation in secondary care.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Recommendations · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“A diet low in fermentable oligosaccharides, disaccharides and monosaccharides and polyols, as a second-line dietary therapy, is an effective treatment for global symptoms and abdominal pain in IBS, but its implementation should be supervised by a trained dietitian and fermentable oligosaccharides, disaccharides and monosaccharides and polyols should be reintroduced according to tolerance (recomm”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > First-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Plecanatide, another guanylate cyclase-C agonist, is an efficacious second-line drug for IBS with constipation in secondary care.”
- Also stated in: § Recommendations · plain
“Plecanatide, another guanylate cyclase-C agonist, is an efficacious second-line drug for IBS with constipation in secondary care.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Recommendations · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Gut-directed hypnotherapy may be an efficacious treatment for global symptoms in IBS (recommendation: strong, quality of evidence: low).”
- Also stated in: § Recommendations · hedged
“Gut-directed hypnotherapy may be an efficacious treatment for global symptoms in IBS (recommendation: strong, quality of evidence: low).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Recommendations · hedged
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Selective serotonin reuptake inhibitors used as gut-brain neuromodulators may be an effective second-line drug for global symptoms in IBS.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Certain antispasmodics may be an effective treatment for global symptoms and abdominal pain in IBS.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > First-line treatments
hedgedconditional- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Tricyclic antidepressants used as gut-brain neuromodulators are an effective second-line drug for global symptoms and abdominal pain in IBS.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“5-Hydroxytryptamine 3 receptor antagonists are efficacious second-line drugs for IBS with diarrhoea in secondary care.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Polyethylene glycol may be an effective treatment for constipation in IBS.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > First-line treatments
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It is important to point out that most RCTs of first-line treatments, as well as gut-brain neuromodulators and psychological therapies, used less rigorous end points to judge treatment efficacy, such as improvement in, or satisfactory relief of, global symptoms or abdominal pain.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Methodology for systematic reviews of IBS therapy
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Subgroup analyses according to type of probiotic used (where more than one trial of a particular group of probiotics was conducted) demonstrated significant effects on global symptoms or abdominal pain for combinations of probiotics (RR 0.79; 95% CI 0.70 to 0.89), Lactobacillus (RR 0.75; 95% CI 0.60 to 0.94), Bifidobacterium (RR 0.80; 95% CI 0.70 to 0.91) and Escherichia (RR 0.86; 95% CI 0.79 to 0”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Probiotics
boosteddirectn = 6,352 ·- Asserted: passes — The authors put it forward as true.
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In the paper
“A meta-analysis of 8 RCTs, which included 823 patients, has evaluated its efficacy.162”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Not checked — no full text of the sourcecites [162] source
plainn = 823- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Subgroup analyses according to type of probiotic used (where more than one trial of a particular group of probiotics was conducted) demonstrated significant effects on global symptoms or abdominal pain for combinations of probiotics (RR 0.79; 95% CI 0.70 to 0.89), Lactobacillus (RR 0.75; 95% CI 0.60 to 0.94), Bifidobacterium (RR 0.80; 95% CI 0.70 to 0.91) and Escherichia (RR 0.86; 95% CI 0.79 to 0”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Probiotics
boosteddirectn = 6,352 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Subgroup analyses according to type of probiotic used (where more than one trial of a particular group of probiotics was conducted) demonstrated significant effects on global symptoms or abdominal pain for combinations of probiotics (RR 0.79; 95% CI 0.70 to 0.89), Lactobacillus (RR 0.75; 95% CI 0.60 to 0.94), Bifidobacterium (RR 0.80; 95% CI 0.70 to 0.91) and Escherichia (RR 0.86; 95% CI 0.79 to 0”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Probiotics
boosteddirectn = 6,352- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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In the paper
“For global symptoms or abdominal pain, peppermint oil was more efficacious than placebo (RR 0.58; 95% CI 0.34 to 0.98) (online supplemental figure 5).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Not checked — no full text of the sourcecites [162] source
plaindirectn = 823 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Subgroup analyses according to type of probiotic used (where more than one trial of a particular group of probiotics was conducted) demonstrated significant effects on global symptoms or abdominal pain for combinations of probiotics (RR 0.79; 95% CI 0.70 to 0.89), Lactobacillus (RR 0.75; 95% CI 0.60 to 0.94), Bifidobacterium (RR 0.80; 95% CI 0.70 to 0.91) and Escherichia (RR 0.86; 95% CI 0.79 to 0”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Probiotics
boosteddirectn = 6,352 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Adverse event rates were similar in the probiotic and placebo arms.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Probiotics
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Rates of ischaemic colitis observed since reintroduction are similar to the background rate in female patients with IBS. 235”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Not checked — no full text of the sourcecites [235] source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Constipation is the most common side effect.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Third, patient and public involvement exercises have identified that trial protocols are onerous and unrealistic.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > RESEARCH: BARRIERS, PRIORITIES AND IMPLICATIONS FOR FUTURE STUDY DESIGN
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“For some patients with IBS, psychological comorbidity or distress may be a consequence, rather than a cause, of the severity and frequency of symptoms experienced.31”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > PATHOPHYSIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [31] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Hypersensitivity to mechanical distension of the gut is reported by more patients with IBS-D than IBS-C.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Altered visceral perception
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Symptoms compatible with IBS are extremely common in the general population at any particular point in time, 11 and experienced on a continuum, from what may be fleeting and part of normal health, to a disease process, requiring medical input.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > EPIDEMIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [11] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is likely to be the most efficacious secretagogue available for IBS with constipation, although diarrhoea is a common side effect (recommendation: strong, quality of evidence: high).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“A study conducted in separate patient cohorts from Sweden, Belgium and the USA reported that visceral sensitivity correlated positively with symptom severity, even after adjustment for the tendency to report symptoms or psychological comorbidity.42”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Altered visceral perception
What the sources say
- Not checked — no full text of the sourcecites [42] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Second, the minimum required frequency of abdominal pain was increased from at least 3 days per month, to at least 1 day per week.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLASSIFICATION AND DIAGNOSTIC CRITERIA
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This drug class is likely the most efficacious for IBS with diarrhoea (recommendation: weak, quality of evidence: moderate to high).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
hedgeddirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“High amplitude propagating contractions in patients with IBS-D are associated with abdominal pain. 1”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Transit and motility
What the sources say
- Not checked — no full text of the sourcecites [1] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, a meta-analysis of genes associated with inflammatory mediators found no significant associations for most genes assessed.79”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Genetics and epigenetics
What the sources say
- Not checked — no full text of the sourcecites [79] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“There is no conclusive evidence for a specific IBS gut microbiome profile.74 75”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > The microbiome
What the sources say
- Not matchedcites 74 75
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“However, symptoms of abdominal pain, bloating and flatulence correlate poorly, or not at all, with colonic transit, 45 46”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Transit and motility
What the sources say
- Not matchedcites 45 46
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Mast cell hyperplasia is more common in IBS-D and PI-IBS.52 55”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
- Not matchedcites 52 55
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Confocal laser endomicroscopy studies suggest exposure to certain food antigens can disrupt the epithelial barrier in approximately 50% of patients with IBS.67 68”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
- Not matchedcites 67 68
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“There is lack of consensus on whether numbers of T cells and levels of cytokines in the peripheral circulation of patients with IBS are abnormal.52 53”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
- Not matchedcites 52 53
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Increased numbers of mast cells, particularly in the descending colon and rectosigmoid region, 52 53 and in the small intestine, 54 is the most consistent histological finding in IBS.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
- Not matchedcites 52 53
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [54] Robles, 2019, Mast cells are increased in the small intestinal mucosa of patients with irritable bowel syndrome: a systematic review and meta‐analysis, Neurogastroenterology & Motility source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“The chance of identifying organic disease on the basis of checking FBC, CRP and ESR in suspected IBS is low, 100”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigation in primary care
What the sources say
- Not checked — no full text of the sourcecites [100] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Familial clustering of IBS may be attributed to both genetic and shared environmental factors.77 78”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Genetics and epigenetics
What the sources say
- Not matchedcites 77 78
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“However, findings in patients with IBS-C are inconsistent.64 65”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
- Not matchedcites 64 65
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“In addition, numerous genetic single nucleotide polymorphisms have been described in association with symptom phenotypes, regulation of neurotransmission, barrier function, inflammatory mediators, ion channels and bile acid metabolism in IBS.77 78”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Genetics and epigenetics
What the sources say
- Not matchedcites 77 78
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Similar observations are seen for oro-caecal transit.46 47”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Transit and motility
What the sources say
- Not matchedcites 46 47
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“However, the effect was modest and there are concerns regarding the poor specificity and applicability of IgG antibody testing.196”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Not checked — no full text of the sourcecites [196] Hunter, 2005, Food elimination in IBS: the case for IgG testing remains doubtful, Gut
plaindirectn = 150- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“There are multiple mechanisms by which food may trigger symptoms in IBS, including primary effects (eg, osmotic, chemical, immunological, mechanical or neuroendocrine) and secondary effects (eg, fermentation by-products, alterations in intraluminal pH or effects on the gut microbiome).193 194”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the evidence for this is based on a combination of clinical experience and the potential mechanisms by which these foods may induce gastrointestinal symptoms in IBS, rather than evidence from RCTs of this approach versus a control treatment.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In a patient with normal investigations from primary care on referral, exhibiting typical symptoms, and in the absence of alarm symptoms or signs, or atypical features, the diagnosis of IBS is secure (figure 1).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigations in secondary care
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Hence, the benefits of adopting a low FODMAP diet in IBS seem physiologically plausible and several RCTs have evaluated its efficacy in IBS.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Over 80% of individuals with IBS report food-related symptoms, especially to fermentable carbohydrates and fats.188 189”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Common mental disorders, and somatoform-type behaviour, often coexist.119 120”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLINICAL HISTORY AND INVESTIGATION IN SECONDARY CARE The first consultation in secondary care
What the sources say
- Not matchedcites 119 120
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“There is evidence that patient education about the condition can lead to an improvement in symptoms.148”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Communicating a positive diagnosis and management plan in secondary care
What the sources say
- Not checked — no full text of the sourcecites [148] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, RCTs have focused solely on the initial 'elimination' phase of the low FODMAP diet, which lasts between 4 and 6 weeks, not the subsequent reintroduction and long-term 'personalisation' phase.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The latter has mainly been attributed to the various control interventions used.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Variations in study design, strain and species of probiotic used, and heterogeneity between studies make it difficult to give specific recommendations.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Probiotics
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is, therefore, insufficient evidence to recommend a gluten-free diet routinely in IBS, although given its widespread popularity further RCTs are needed.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
plainn = 111- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Interestingly, those studies that compared the low FODMAP diet with traditional dietary advice from NICE and the BDA had the least heterogeneity, but also the least magnitude of effect (RR 0.82; 95% CI 0.67 to 1.01), suggesting that the 50%-70% symptomatic benefit reported for a low FODMAP diet in some studies may have been overestimated.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The effect of these drugs on stool pattern is less clear, as very few trials restricted their recruitment to a particular subgroup of patients.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The efficacy of rifaximin, a non-absorbable antibiotic, has also been tested in IBS-D, on the basis that disturbances in the gastrointestinal microbiota may, in part, be responsible for symptoms.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The drug is contraindicated in patients with prior sphincter of Oddi problems or cholecystectomy, alcohol dependence, pancreatitis or severe liver impairment.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A previous meta-analysis of 11 RCTs demonstrated that tegaserod was superior to placebo for the treatment of IBS-C in 9242 patients (RR 0.85; 95% CI 0.80 to 0.90) (online supplemental figure 18). 163”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Not checked — no full text of the sourcecites [163] source
boosteddirectn = 9,242- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is likely to be the most efficacious secretagogue available for IBS with constipation, although diarrhoea is a common side effect”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Recommendations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“in the largest clinical series to date, including 1000 patients, >75% of patients achieved a clinical response to hypnotherapy, defined as a ≥50-point reduction in IBS symptom severity score.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Not checked — no full text of the sourcecites [252] source
plaindirectn = 1,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Evidence from a large cohort of patients with severe chronic continuous abdominal pain showed that combinations of neuropathic analgesics (eg, duloxetine plus gabapentin) were more efficacious than monotherapy.287”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Guidelines
What the sources say
- Not checked — no full text of the sourcecites [287] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“there is recent trial data reporting superior outcomes with an integrated approach involving gastroenterologists, dietitians and clinical psychologists, rather than a gastroenterologist alone.277”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Guidelines
What the sources say
- Not checked — no full text of the sourcecites [277] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Patients with IBS with severe symptoms are more willing to accept significant medication risks, for example, a mean 1% chance of sudden death in return for a 99% chance of cure of their symptoms with a hypothetical medication.279”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Guidelines
What the sources say
- Not checked — no full text of the sourcecites [279] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among individuals who believe themselves to have IBS, only around 60% fulfil Rome IV criteria”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > RESEARCH: BARRIERS, PRIORITIES AND IMPLICATIONS FOR FUTURE STUDY DESIGN
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The geographical exclusion produced by site-dependent recruitment can be overcome by a remote access, or virtual, approach.298”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > RESEARCH: BARRIERS, PRIORITIES AND IMPLICATIONS FOR FUTURE STUDY DESIGN
What the sources say
- Not matchedcites [298] Yiannakou Y . Virtual trials: transforming the landscape of clinical research. National health executive magazine January, 2021. Available: https://mag.nationalhealthexecutive.com/publication/?m=62920&i=691004&p=44&article_id=3863994
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At present, therefore, there is insufficient evidence to recommend FMT for IBS outside of a research setting.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Other treatments in development
plainn = 267- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 121
- Probably not a substantial claim. 30
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“Alosetron was withdrawn from the market in 2001 due to reports of ischaemic colitis. 234 However, it was reintroduced in the USA via a risk evaluation and mitigation strategy, at a lower dose of 0.5 mg two times per day, for women with severe IBS-D.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Disputedcites [234] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 1 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Checked by a reasoning model — may be wrong.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Disputed
Every source the paper cites for this claim was checked and supports it.
In the paper
“Symptoms are generated by interoceptive signals from the gut, and memories of such signals, and are modulated by emotional (anxiety, depression), cognitive (attention, beliefs and expectation) and motivational factors.33”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Central nervous system and autonomic nervous system modulation
What the sources say
- Supportedcites [33] source
The Introduction states that subjective symptom reports in disorders of brain–gut interaction are generated in part from GI interoceptive signals and memories of them, and are modulated by emotional, cognitive and motivational factors. Its discussion of IBS-related threat appraisal and expectations also supports the citing sentence’s reference to beliefs. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“IBS is a disorder of altered bidirectional communication between the gut and brain (via the gut-brain axis), and has a biopsychosocial aetiology.32”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > PATHOPHYSIOLOGY
What the sources say
- Supportedcites [32] source
The Special Issue Editors section classifies IBS as a functional gastrointestinal disorder and describes these disorders as gut–brain interactions understood through a biopsychosocial model. It also describes altered gut signaling and central nervous system modulation of gut function, supporting the paraphrase about communication in both directions. The supplied copy gives no page number for these passages. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“resulting in its re-classification as a disorder of gut-brain interaction, rather than a functional gastrointestinal disorder.”
- Also stated in: § CLASSIFICATION AND DIAGNOSTIC CRITERIA · plain
“The Rome IV process also redefined IBS as a disorder of gut-brain interaction, in recognition of the complex interplay of biological, psychological, and social factors underpinning the condition.”
- Also stated in: § PATHOPHYSIOLOGY · plain
“As a result, it has been re-termed a disorder of gut-brain interaction.32”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Abstract
What the sources say
- Partly supportedcites [32] sourceExperimental — accuracy not yet measured
The Special Issue Editors section says functional GI disorders are “better defined as Disorders of Gut-Brain Interaction,” supporting the terminology used for IBS. But its Table 1 still lists IBS under “Functional Gastrointestinal Disorders,” so the source does not support treating the two labels as mutually exclusive. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § CLASSIFICATION AND DIAGNOSTIC CRITERIA · plain
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Reduced vagal tone may be caused by stress, and impacts on gut motility and sensitivity, and peripheral inflammation and gut permeability.40”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Central nervous system and autonomic nervous system modulation
What the sources say
- Partly supportedcites [40] Bonaz, 2018, The vagus nerve at the interface of the microbiota-gut-brain axis, Front Neurosci sourceExperimental — accuracy not yet measured
The Introduction and “Stress, vagus nerve, and the microbiota” section say stress inhibits the vagus nerve and blunts its anti-inflammatory action. “Brain to gut interactions” says low vagal activity increases intestinal permeability and promotes systemic inflammation. The copy does not clearly establish the additional claim that reduced vagal tone affects gut motility and sensitivity. (LLM, conf=0.84)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Approximately 20% of patients with IBS are viscerally hyposensitive or insensitive to mechanical distension, more commonly those with IBS-C than IBS-D, with one study suggesting that the degree of insensitivity correlated with abdominal distension (ie, a true physical increase in abdominal girth).43”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Altered visceral perception
What the sources say
- Supportedcites [43] source
The Hyper-vs Normo-vs Hyposensitive Patients section reports that 22% of the IBS patients studied were hyposensitive to rectal distention, including 28% of IBS-C patients and 14% of IBS-D patients. The Discussion also says that patients with higher pain thresholds distended more during the day, supporting the additional point in the citing sentence. Page numbers are not available in the supplied passages. (LLM, conf=0.93)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Colonic transit time correlates inversely with stool consistency and, to a lesser extent, with stool frequency.45”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Transit and motility
What the sources say
- Supportedcites [45] source
The ‘Total and segmental transit time, bowel habits, and GI symptoms’ section reports negative correlations between total colonic transit time and both stool form (ρ = −0.41) and stool frequency (ρ = −0.37) in patients with IBS. The discussion also describes stool frequency as a less reliable marker of transit than stool form. Page numbers were not supplied in the copy. (LLM, conf=0.92)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“The severity and frequency of abdominal pain correlates with the presence of activated mast cells in close proximity to nerve endings in the gut mucosa in some studies, 56 but in others mast cell proliferation associates with a reduction, 57 or no change, 58 in visceral sensitivity.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“There is some evidence for epigenetic changes in IBS, including alterations in DNA methylation, and various miRNAs appear to be associated with increased visceral sensitivity and permeability.80”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Genetics and epigenetics
What the sources say
- Supportedcites [80] Mahurkar-Joshi, 2020, Epigenetic mechanisms in irritable bowel syndrome, Front Psychiatry source
The Abstract describes emerging evidence of DNA methylation changes in IBS models and patients, and miRNAs associated with increased visceral sensitivity and intestinal permeability. The DNA Methylation and MicroRNA sections provide examples of those associations. (LLM, conf=0.95)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Nevertheless, lower gastrointestinal symptoms frequently prompt people to present to primary care, 81 accounting for approximately 1 in 12 of all consultations.82”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > PRESENTATION OF IBS, DIAGNOSIS AND MANAGEMENT IN PRIMARY CARE Overview
What the sources say
- Could not verifycites [81] sourceExperimental — accuracy not yet measured
Citation 82 is attached to the estimate that lower gastrointestinal symptoms account for approximately 1 in 12 primary-care consultations. The Discussion instead reports that IBS or IBS-related symptoms account for approximately 7.5% of outpatient attendances across all specialties; the Introduction describes a primary-care burden but gives no proportion of all primary-care consultations. Searches for the one-in-twelve estimate and a primary-care consultation percentage found no supporting passage. (LLM, conf=0.75)
- Partly supportedcites [82] sourceExperimental — accuracy not yet measured
The Discussion states that gastrointestinal problems account for about one in 12 primary-care consultations. The Screening and Demographics section likewise reports gastrointestinal complaints in 8.2% of screened patients. Neither passage limits that figure to lower gastrointestinal symptoms, so the claim is narrower than the source supports. (LLM, conf=0.87)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Could not verify
Every source the paper cites for this claim was checked and supports it.
In the paper
“whereas abdominal distension (the physical increase in abdominal girth, rather than the sensation of bloating) correlates with oro-caecal and colonic transit times, and inversely with stool consistency.46”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Transit and motility
What the sources say
- Supportedcites [46] source
The Correlations section reports that, in patients with IBS-C, abdominal distension correlated directly with orocecal and colonic transit times and inversely with Bristol Stool Score. The inverse stool-score correlation had P = 0.07, so that finding should not be read as statistically significant. (LLM, conf=0.90)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In a mouse model, bacterial infection led to an increase in intestinal permeability, which appeared to allow previously tolerated food antigens to activate a localised host immune response in the gastrointestinal tract, via IgE, leading to histamine release, altered motility and visceral hypersensitivity.73”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > The microbiome
What the sources say
- Partly supportedcites [73] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Changes in gastrointestinal motility may be influenced by alterations in serotonin (5-Hydroxytryptamine (5-HT)) metabolism, 49 with high levels reported in patients with IBS-D, and low levels in IBS-C.50”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Transit and motility
What the sources say
- Not checked — no full text of the sourcecites [49] source
- Supportedcites [50] source
Citation 50 is attached to the comparison of serotonin levels in IBS-D and IBS-C. The Platelet-Depleted Plasma 5-HT Concentrations section (page not available) reports elevated plasma 5-HT in IBS-D and lower post-meal levels in IBS-C than in healthy volunteers and IBS-D patients. The distinction is condition-specific: fasting levels in IBS-C did not differ from healthy volunteers. (LLM, conf=0.90)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Functional gastrointestinal disorders, such as IBS, are by far the most common diagnosis, but symptoms can be difficult to assess and the possibility of colorectal cancer or inflammatory bowel disease (IBD) may create diagnostic uncertainty for clinicians, and anxiety for patients.83”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > PRESENTATION OF IBS, DIAGNOSIS AND MANAGEMENT IN PRIMARY CARE Overview
What the sources say
- Partly supportedcites [83] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“General practitioners provide the majority of long-term medical care for people with IBS, referring only a minority of patients to specialist clinics.86”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > PRESENTATION OF IBS, DIAGNOSIS AND MANAGEMENT IN PRIMARY CARE Overview
What the sources say
- Partly supportedcites [86] sourceExperimental — accuracy not yet measured
The Methods (Description of CBT interventions and TAU; page unavailable) describe usual GP or consultant follow-up, supporting that GPs provide ongoing care for some patients with IBS. The paper does not establish that GPs provide the majority of long-term care or that only a minority of patients are referred to specialist clinics. (LLM, conf=0.83)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Interleukin-10 mRNA expression and protein levels are consistently reduced in the mucosa and/or peripheral circulation, in patients with IBS-D and PI-IBS, and associate with comorbid anxiety or depression.59”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
- Partly supportedcites [59] sourceExperimental — accuracy not yet measured
The Results sections comparing IBS-D patients with controls and comparing patients with and without anxiety-depression report lower IL-10 levels in blood and sigmoid colon mucosa. The Methods describe protein-level assays and immunohistochemistry, not mRNA measurement; the paper does not report findings for PI-IBS. No page numbers are available in our copy. (LLM, conf=0.90)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“They may also trigger bowel symptoms as they produce short chain fatty acids, which lower colonic pH.202”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Partly supportedcites [202] Spiller, 2021, Impact of diet on symptoms of the irritable bowel syndrome, Nutrients sourceExperimental — accuracy not yet measured
Section 5 links FODMAP fermentation to bowel symptoms and suggests that short-chain fatty acids could mediate mast-cell activation. But it attributes the fall in pH to accumulated lactate, not to short-chain fatty acids, so the claimed pH mechanism is not supported. (LLM, conf=0.88)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Patients reporting adverse food reactions experience more severe gastrointestinal symptoms, associated subjective health complaints of musculoskeletal pains and chronic fatigue and reduced quality of life, compared with those without food sensitivities.[189][190][191]”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Not checked — no full text of the sourcecites [189] source
- Not checked — no full text of the sourcecites [190] source
- Partly supportedcites [191] sourceExperimental — accuracy not yet measured
The Discussion reports that many patients with perceived food hypersensitivity had musculoskeletal pain and chronic fatigue in addition to IBS, and the Conclusions describe these as prevalent comorbidities. However, the study enrolled patients with perceived food hypersensitivity only; it does not establish that their symptoms were more severe, or their quality of life lower, than in people without food sensitivities. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Evidence suggests that 2 minutes of active listening at the beginning of a consultation gives the patient the feeling of having being listened to, 109 and therefore having confidence in subsequent decisions around their care.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLINICAL HISTORY AND INVESTIGATION IN SECONDARY CARE The first consultation in secondary care
What the sources say
- Partly supportedcites [109] sourceExperimental — accuracy not yet measured
The Participants, methods, and results section reports that doctors used active-listening techniques and that 78% of patients finished their initial statement within two minutes. The paper does not report whether patients felt listened to or had greater confidence in subsequent care decisions; it measured talking time, not those perceptions. (LLM, conf=0.85)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“although the diagnostic performance of alarm symptoms or signs is modest, 122 and up to 80% of patients with IBS in primary and secondary care will report at least one alarm symptom.123”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigations in secondary care
What the sources say
- Not checked — no full text of the sourcecites [122] source
- Partly supportedcites [123] sourceExperimental — accuracy not yet measured
The citation is attached to the prevalence claim, not the preceding statement about diagnostic performance. The Gastroenterologists vs. primary care section (p. 6) reports that 84.3% of patients with a clinical IBS diagnosis in the combined primary-care and gastroenterology sample reported a red flag. This supports the general point, but the reported figure exceeds the claimed 'up to 80%' bound. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The yield of colonoscopy in patients with IBS is extremely low, 125 and there is no evidence of reassurance being derived by patients from a normal examination.126”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigations in secondary care
What the sources say
- Partly supportedcites [125] sourceExperimental — accuracy not yet measured
The Discussion reports that colonoscopy did not alter the IBS diagnosis in 457 of 466 patients (98.1%), supporting the claim of low diagnostic yield. The study included patients with non-constipated IBS and no warning signs, so it does not establish the yield for all patients with IBS. The reassurance clause is attached to a different citation and is not assessed here. (LLM, conf=0.85)
- Not checked — no full text of the sourcecites [126] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“They increase small intestinal water volume and colonic gas production and, in those with visceral hypersensitivity, induce gastrointestinal symptoms.201”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Supportedcites [201] source
The Secondary endpoints section reports increased small-bowel water after fructose and increased colonic gas after inulin, compared with glucose. The Discussion attributes carbohydrate-related symptoms in patients with IBS to visceral hypersensitivity rather than greater gas production in those who develop symptoms. The paper thus supports the claim about these effects of FODMAPs, without implying that every FODMAP produces both effects. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Studies using small intestinal aspiration, considered the gold standard for diagnosing small intestinal bacterial overgrowth, have not demonstrated an increased prevalence of the condition in suspected IBS, 143 and the lactulose breath test correlates poorly with small intestinal aspiration.144”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigations in secondary care
What the sources say
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“For example, IgG antibodies to yeast were reported in 87% of patients yet are rarely responsible for symptoms following dietary rechallenges.195 196”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Partly supportedcites [195] sourceExperimental — accuracy not yet measured
Table 2 (Discussion; page not provided) lists yeast among the foods excluded for 86.7% of the treatment group, consistent with the rounded 87% figure, but it does not establish that percentage for all patients. The Reintroduction of eliminated foods section reports symptoms after foods were reintroduced as a group; it does not report yeast-specific rechallenge results or say yeast was rarely responsible for symptoms. (LLM, conf=0.88)
- Not matchedcites [196] Hunter, 2005, Food elimination in IBS: the case for IgG testing remains doubtful, Gut
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“IBS is one of the most common disorders that gastroenterologists deal with, accounting for at least 10% of consultations in the outpatient clinic.105”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLINICAL HISTORY AND INVESTIGATION IN SECONDARY CARE The first consultation in secondary care
What the sources say
- Partly supportedcites [105] sourceExperimental — accuracy not yet measured
The Results report IBS in 62 of 613 patients (10.1%), and the Discussion identifies it as one of the commonest functional gastrointestinal disorders seen. The study counted consecutive new referrals to one luminal gastroenterology clinic, not all outpatient consultations, including follow-up visits. (LLM, conf=0.83)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“including previous acute enteric infection, present in approximately 10% of people with IBS, 112”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLINICAL HISTORY AND INVESTIGATION IN SECONDARY CARE The first consultation in secondary care
What the sources say
- Supportedcites [112] source
The Diagnosis of PI-IBS section reports that 1004 of 7552 people with IBS (13.3%) met the study’s criteria for post-infectious IBS. The Discussion also reports a conservative estimate of 9%. Both support the claim’s approximate 10% figure, though the study’s own internet-survey estimate was 13.3%. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The presence of bloating is not required to fulfil the Rome IV criteria but, if present, is highly suggestive of IBS, and is often accompanied by visible abdominal distension.114”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLINICAL HISTORY AND INVESTIGATION IN SECONDARY CARE The first consultation in secondary care
What the sources say
- Partly supportedcites [114] sourceExperimental — accuracy not yet measured
The Results (p. 1) report greater bloating in IBS patients than controls and distention in 48% of patients; the Discussion (p. 7) notes that some IBS patients do not experience bloating. However, the study used Rome II criteria, not Rome IV, and does not establish that bloating is highly suggestive of IBS; seven of 20 healthy volunteers also reported bloating (p. 3). (LLM, conf=0.88)
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“However, this effect was limited to soluble fibre, such as ispaghula (RR 0.83; 95% CI 0.73 to 0.94), but not insoluble fibre, like wheat bran, which may exacerbate abdominal pain and bloating.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Could not verifycites [158] sourceExperimental — accuracy not yet measured
The ‘Efficacy and Safety of Prebiotics in IBS’ section (page unavailable) discusses fructooligosaccharides and trans-galactooligosaccharides, not a comparison of soluble and insoluble fibre. Searches for ispaghula, wheat bran, soluble fibre, and the stated RR and confidence interval found no passage supporting the claim or its statement about worsened pain and bloating. (LLM, conf=0.77)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“An empathic approach can improve quality of life and symptoms, 110 reduce healthcare visits and enhance adherence to treatment.108 111”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLINICAL HISTORY AND INVESTIGATION IN SECONDARY CARE The first consultation in secondary care
What the sources say
- Not checked — no full text of the sourcecites [108] source
- Partly supportedcites [110] sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) says that helping patients make sense of their IBS could improve quality of life, and the paper links a mutually understanding doctor–patient relationship with maintaining quality of life. It does not report that an empathic approach improves symptoms, reduces healthcare visits, or increases treatment adherence; its exploratory findings also do not establish that the approach causes improvement. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [111] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“All patients should be advised of the potential benefits of regular exercise, as there is some evidence from RCTs that this can be beneficial, 150 151 particularly for constipation, 150 with beneficial effects still apparent at 5 years in one trial.152”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > TREATMENT OF IBS General overview
What the sources say
- Not matchedcites 150 151
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [150] source
- Supportedcites [152] source
Citation 152 is attached to the claim that benefits remained apparent at five years, not to the separate constipation claim. The Discussion reports positive clinical effects after approximately five years of follow-up in patients who had undergone an intervention to increase physical activity. (LLM, conf=0.93)
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Symptoms of BAD can mimic IBS-D, with between one-in-three and one-in-four patients with suspected IBS-D having an abnormal SeHCAT retention, 133 134 and response rates to a bile acid sequestrant are higher at retentions of <10% or <5%.135”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigations in secondary care
What the sources say
- Not matchedcites 133 134
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Supportedcites [135] source
Citation 135 is attached to the treatment-response claim. The Abstract reports that response to colestyramine, a bile acid binder, rose from 70% at SeHCAT retention <15% to 80% at <10% and 96% at <5%. (LLM, conf=0.94)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Patients meeting these criteria were 21 times more likely to have IBS-C than to not have IBS-C, and 11 times more likely to have IBS-M than to not have IBS-M after limited diagnostic workup.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigations in secondary care
What the sources say
- Partly supportedcites [21] sourceExperimental — accuracy not yet measured
The Validation of the Rome IV Criteria for IBS section reports positive likelihood ratios of 25.7 for IBS with constipation and 10.6 for IBS with mixed bowel habits; the latter is approximately 11, but the former is not 21. The Introduction’s figure of 21 concerns IBS overall in an earlier validation study, not IBS-C in this study. The Investigative Work-up section describes a standardised but non-exhaustive work-up. (LLM, conf=0.89)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Overall, adverse events with peppermint oil were no more common than placebo, 160 although patients can report gastro-oesophageal reflux symptoms due to its effects on the lower oesophageal sphincter.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [160] source
The Quality of evidence: Low section reports that pooled adverse events were not significantly higher with peppermint oil than placebo. The Summary likewise says adverse events appeared no more common with peppermint oil; it also reports heartburn and suggests relaxation of esophageal muscle as a possible explanation. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although the drug improved stool frequency and consistency, it had no effect on global symptoms (RR 0.44; 95% CI 0. 14 to 1 42).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Partly supportedcites [160] sourceExperimental — accuracy not yet measured
The “9. Loperamide” section (page not available) reports no statistically significant improvement in overall IBS symptoms compared with placebo. It gives RR 0.42, not the claimed 0.44, and does not report improvement in stool frequency or consistency. A nonsignificant result also does not establish that loperamide had no effect. (LLM, conf=0.88)
plainn = 42- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Issues with following a low FODMAP diet, as opposed to traditional dietary advice, include the need for a specialist dietitian to implement it, followed by close monitoring to avoid nutritional deficiencies or the development of overly restrictive eating habits.[207][208][209]”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Partly supportedcites [207] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Supportedcites [208] Wilson, 2020, Challenges of the low FODMAP diet for managing irritable bowel syndrome and approaches to their minimisation and mitigation, Proc Nutr Soc source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [209] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In contrast, in this meta-analysis, neither alverine nor mebeverine demonstrated benefit over placebo.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [160] source
The Antispasmodics section states that mebeverine and alverine, each evaluated in one trial, did not have a statistically significant effect on IBS symptoms. It cautions that the numbers of patients studied were small. (LLM, conf=0.94)
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Although both stimulant and osmotic laxatives are efficacious in the treatment of chronic idiopathic constipation, 220 only the latter have been evaluated in 2 RCTs of polyethylene glycol, recruiting 181 patients with IBS-C.221 222”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [220] source
Citation 220 is attached to the claim that both stimulant and osmotic laxatives are efficacious for chronic idiopathic constipation. The 'Efficacy and safety of laxatives in CIC' section reports better response than placebo for each, and the Discussion likewise states beneficial effects for both. The separate IBS-C trial claim is attached to citations 221 and 222, not this source. (LLM, conf=0.94)
- Not checked — no full text of the sourcecites [221] source
- Not checked — no full text of the sourcecites [222] source
plainn = 181- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Comparison of peppermint oil and antispasmodics with other unlicensed or 'traditional' treatments for IBS, including ispaghula and gutbrain neuromodulators, in a network meta-analysis suggested that, for global symptoms, peppermint oil was ranked first and antispasmodics third, with both superior to placebo (online supplemental figure 6).157”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [157] source
The Global IBS Symptoms results (p. 18) rank peppermint oil first and antispasmodic drugs third in the Western-trials sensitivity analysis. The Discussion (p. 22) reports that both were significantly more efficacious than placebo for global symptoms, while noting no significant differences between active treatments. (LLM, conf=0.90)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Preliminary data suggest that response to a low FODMAP diet may be predicted from baseline faecal bacterial profile and metabolomic activity, while a gluten-free diet may benefit those with serum antigliadin antibodies.[213][214][215]”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Not checked — no full text of the sourcecites [213] source
- Supportedcites [214] source
The Discussion (page not provided) reports that baseline faecal volatile-organic-compound profiles predicted response to a low-FODMAP diet and describes earlier studies using bacterial profiles. This supports the preliminary claim about baseline bacterial and metabolomic predictors. The gluten-free-diet and antigliadin-antibody clause is not attributed to this paper specifically within the three-citation cluster. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [215] Pinto-Sanchez MI , Nardelli A , Borojevic R , et al . Gluten-Free Diet Reduces Symptoms, Particularly Diarrhea, in Patients With Irritable Bowel Syndrome and Antigliadin IgG. Clinical Gastroenterology and Hepatology 2020;150.doi:10.1016/j.cgh.2020.08.040 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“We updated a prior meta-analysis of 37 RCTs, 158 incorporating data from 8 new trials [166][167][168][169][170][171][172][173] and randomising 6352 patients.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Probiotics
What the sources say
- Supportedcites [158] source
The Efficacy of Probiotics in the Treatment of IBS section (page unavailable) reports a meta-analysis of 37 probiotic-versus-placebo RCTs, supporting the description of the cited prior analysis. The eight new trials and 6,352 patients describe the citing authors’ update, not a result attributed to this source. (LLM, conf=0.91)
- Not checked — no full text of the sourcecites [166] Barraza-Ortiz, 2020, Combination of a probiotic and an antispasmodic increases quality of life and reduces symptoms in patients with irritable bowel syndrome: a pilot study, Dig Dis source
- Not checked — no full text of the sourcecites [167] source
plainn = 6,352- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The overall rates of adverse events were significantly higher with antispasmodics compared with placebo; most notably dry mouth, visual disturbance and dizziness.160”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [160] source
The Antispasmodics section reports that pooled adverse-event incidence was significantly higher with antispasmodics than with placebo (RR 1.60; 95% CI 1.15–2.21). It names dry mouth, dizziness, and blurred vision as the commonest adverse events; blurred vision matches the claim’s visual disturbance. (LLM, conf=0.94)
plaindirectn = 426- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The prior systematic review and meta-analysis identified only 2RCTs, 161 comprising 111 participants and noted that although a gluten-free diet was associated with a reduction in global symptoms compared with a control diet, this was not statistically significant (RR 0.42; 95% CI 0. 11 to 1 55).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Supportedcites [161] source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaincorrelationaln = 111- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In terms of effect on abdominal pain, antispasmodics ranked second, with peppermint oil third (online supplemental figure 7).Again, both were significantly more efficacious than placebo.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Supportedcites [157] source
The ‘Failure to Achieve an Improvement in Abdominal Pain’ section (p. 19) states that antispasmodic drugs ranked second and peppermint oil third. It also reports that both were significantly more efficacious than placebo at 4–12 weeks. (LLM, conf=0.95)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Adverse events included constipation, nausea and headache, and adverse events leading to drop out were significantly higher with active drug than placebo.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [153] sourceExperimental — accuracy not yet measured
The Outcome assessment section (page unavailable) lists constipation, nausea and headache among the individual adverse events assessed. The Safety section (page unavailable) reports significantly more adverse-event-related dropouts than placebo for both studied doses of eluxadoline and for alosetron 1 mg twice daily, but not for active drugs generally. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Pregabalin improved visceral hypersensitivity in one small trial, 227 and in a recent RCT recruiting 85 patients with IBS, 12 weeks of pregabalin 225 mg twice daily led to significant improvements in global symptoms, abdominal pain, diarrhoea and bloating versus placebo.228”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
What the sources say
plaindirectn = 85- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In contrast, SSRIs were ranked fifth and fourth for global symptoms and abdominal pain, respectively, and pregabalin was ranked sixth for global symptoms, with no benefit of either over placebo in these trials.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
What the sources say
- Partly supportedcites [157] sourceExperimental — accuracy not yet measured
The Results on global IBS symptoms (p. 18) and abdominal pain (p. 19) identify only peppermint oil, TCAs, and antispasmodic drugs as significantly more effective than placebo, supporting the statement that SSRIs and pregabalin showed no demonstrated benefit on the relevant endpoints. The passages in our copy do not give the claimed fifth, fourth, and sixth rankings, so those precise ranks remain unsupported. (LLM, conf=0.80)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In a previous metaanalysis, 153 both alosetron 1 mg two times per day and ramosetron 2.5 μg or 5 μg once a day were superior to placebo across various end points, including the FDA composite end point for IBS-D (3 RCTs of alosetron 1 mg two times per day, 787 patients, RR 0.69; 95% CI 0.60 to 0.80, and 1 RCT of ramosetron 2.5 μg once a day, 348 patients, RR 0.78; 95% CI 0.67 to 0.91) (online supp”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [153] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirectn = 787- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In a metaanalysis of 12 RCTs of TCAs, recruiting 787 patients, these drugs were superior to placebo for global symptoms or abdominal pain (RR 0.65; 95% CI 0.55 to 0.77) (online supplemental figure 8), and for abdominal pain alone (RR 0.59; 95% CI 0.42 to 0.83) (online supplemental figure 9).159”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
What the sources say
- Supportedcites [159] source
The Outcome Assessment and Box 2 sections define the main outcome as improvement in global IBS symptoms or, when unavailable, abdominal pain. The Efficacy of Antidepressants in the Treatment of IBS section reports 12 TCA RCTs with 787 patients, an RR of 0.65 (95% CI 0.55 to 0.77) for symptoms not improving, and an abdominal-pain RR of 0.59 (95% CI 0.42 to 0.83). (LLM, conf=0.95)
plaindirectn = 787- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Both drugs were also more efficacious than placebo for global symptoms, abdominal pain and stool consistency (online supplemental figures 11-13).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Supportedcites [153] source
The Results sections report that all treatments except rifaximin were significantly more effective than placebo for global IBS symptoms, and all treatments were significantly more effective for stool consistency. The abdominal-pain Results explicitly identify both alosetron and ramosetron as significantly more effective than placebo. Page numbers are not available in our copy. (LLM, conf=0.93)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“SSRIs were also more efficacious for global symptoms or abdominal pain (RR 0.68; 95% CI 0.51 to 0.91) (online supplemental figure 8), but not abdominal pain alone (online supplemental figure 9), and there was significant heterogeneity among the 7 trials, which contained only 356 patients.159”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
What the sources say
- Supportedcites [159] source
The Efficacy of Antidepressants in the Treatment of IBS section reports seven SSRI trials with 356 patients, an RR of symptoms not improving of 0.68 (95% CI 0.51–0.91), and statistically significant heterogeneity. The same section reports no statistically significant SSRI effect on abdominal pain alone. The Data Synthesis and Statistical Analysis section defines the pooled outcome as global IBS symptoms or abdominal pain not improving. (LLM, conf=0.94)
plaindirectn = 356- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A network meta-analysis comparing the relative efficacy of all these licensed therapies for IBS-D, across various end points, 153 demonstrated that alosetron 1 mg two times per day ranked first for the FDA composite end point for IBS-D and global symptoms (online supplemental figures 10 and 11), with ramosetron 2.5 μg once a day second.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [153] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Eluxadoline is a μ-opioid and κ-opioid receptor agonist and δ-opioid receptor antagonist licensed for IBS-D. The drug slows intestinal transit and reduces visceral hypersensitivity. 229”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [229] sourceExperimental — accuracy not yet measured
The Background (Mechanism of action; page unavailable) confirms eluxadoline’s receptor profile and approval for IBS-D. The Background (Development; page unavailable) reports normalized GI transit in mice, consistent with slowing transit toward baseline. The paper discusses a rationale for effects on visceral sensation, but does not establish that eluxadoline reduces visceral hypersensitivity. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In a network meta-analysis evaluating relative efficacy of gutbrain modulators with other unlicensed or 'traditional' treatments, 157 TCAs were ranked second and first for their effect on global symptoms and abdominal pain respectively, and were more efficacious than placebo (online supplemental figures 6 and 7).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
What the sources say
- Supportedcites [157] source
The Results report that TCAs ranked second for improvement in global IBS symptoms (p. 18) and first for improvement in abdominal pain (p. 19). Both sections report significantly greater efficacy than placebo in the main analysis. The Discussion (p. 22) notes that the abdominal-pain ranking changed in an analysis restricted to Western trials. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Finally, for stool consistency alosetron 1 mg two times per day ranked first, with ramosetron 5 μg once a day second (online supplemental figure 12).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Supportedcites [153] source
The Results section (‘Failure to achieve a stool consistency response’; page not provided) ranks alosetron 1 mg twice daily first. The Discussion (page not provided) explicitly ranks ramosetron 5 µg once daily second for its effect on stool consistency. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Ramosetron is only available in Asia. 153 There have been no reports of ischaemic colitis associated with the drug.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Supportedcites [153] source
The citation is attached to the availability sentence. The Discussion states that ramosetron is licensed only in Japan and some other South and Southeast Asian countries, supporting the claim that it is available only in Asia. The separate sentence about ischaemic colitis is not attached to this citation. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Adverse events included constipation, nausea and headache; patients assigned to both drugs were more likely to report adverse events than with placebo.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [153] sourceExperimental — accuracy not yet measured
The Safety section (page unavailable) reports significantly more overall adverse events with alosetron 1 mg twice daily and ramosetron 2.5 µg once daily than with placebo. The Discussion identifies constipation as an adverse event, but our copy does not identify nausea or headache among the reported events. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Adverse events were signifi- cantly more common with linaclotide 290 μg once a day, with diarrhoea being the most common.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
The Safety section (p. 19) reports significantly more overall adverse events with linaclotide 290 μg once daily than with placebo (RR 1.12; 95% CI 1.04–1.21). The adverse-event discussion (p. 20) reports an increased risk of diarrhea with linaclotide, but does not establish that diarrhea was its most common adverse event. (LLM, conf=0.85)
plaindirectn = 3,193- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Adverse event rates were significantly higher among patients treated with TCAs or SSRIs, with drowsiness and dry mouth the most common.159”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
What the sources say
- Partly supportedcites [159] sourceExperimental — accuracy not yet measured
The “Adverse Events with Antidepressant Therapy” section reports significantly more adverse events with antidepressants overall and with TCAs specifically. It says drowsiness and dry mouth were more common with TCAs than placebo, but does not establish a significantly higher adverse-event rate for SSRIs separately or identify those effects as the most common across both drug classes. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In a meta-analysis of 2 RCTs, 153 which recruited 1260 patients, rifaximin 550 mg three times a day for 14 days was more efficacious than placebo for the FDA composite end point for IBS-D (RR 0.92; 95% CI 0.86 to 0.98) (online supplemental figure 10) and for stool consistency alone (online supplemental figure 12), but not for global symptoms or abdominal pain (online supple- mental figures 11 and”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [153] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirectn = 1,260- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Drugs acting as antagonists at the 5-HT 3 receptor are also licensed for IBS-D. These include alosetron and ramosetron, which slow gastrointestinal transit, reduce visceral hypersensitivity and alter rectal compliance. [231][232][233]”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [231] sourceExperimental — accuracy not yet measured
The Summary reports that alosetron delayed colonic transit in IBS patients and healthy volunteers. It also describes reduced rectal sensitivity with granisetron, increased rectal compliance with ondansetron, and increased colonic—not rectal—compliance with alosetron. The paper does not establish that alosetron or ramosetron was licensed for IBS-D, or report these effects for ramosetron; the Discussion instead calls alosetron a suitable treatment candidate. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [232] source
- Not checked — no full text of the sourcecites [233] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Headache was the most common adverse event, but side effects were no more common with rifaximin than with placebo.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Partly supportedcites [153] sourceExperimental — accuracy not yet measured
The Safety section (page unavailable) reports that rifaximin ranked best for overall adverse events and does not identify a significant increase versus placebo. The Outcome assessment section lists headache among the adverse events assessed, but our copy does not say it was the most common. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“in the largest trial of CBT for IBS conducted to date at least 50% of patients met cutoffs for probable common mental disorders at baseline, and both therapist-delivered CBT over the telephone and web-based CBT using IBS-specific protocols reduced anxiety and depression scores at all follow-up points.86”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Partly supportedcites [86] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although prucalopride, which is a highly selective 5-HT 4 agonist with no known cardiovascular or cerebrovascular safety concerns, is efficacious in the treatment of chronic idiopathic constipation, 220 to date there have been no RCTs in IBS-C.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [220] sourceExperimental — accuracy not yet measured
The Response to therapy with prucalopride section reports better outcomes than placebo in chronic idiopathic constipation, supporting efficacy. The paper reviews trials in that condition but does not establish the separate claim that no prucalopride RCTs had been conducted in IBS-C; a search for IBS-C trials found no passage addressing it. Page numbers were not available in our copy. (LLM, conf=0.86)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Analysis of trials that only included patients with refractory symptoms reduced the heterogeneity, and still demonstrated efficacy for CBT in some formats (online supple- mental figure 21).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [156] source
The Results section reports very little heterogeneity when analysis was restricted to 13 trials recruiting only patients with refractory IBS; the Discussion describes moderate heterogeneity in the main analysis. The Abstract reports efficacy for group CBT, telephone CBT, and internet CBT against specified controls in the refractory-symptom trials. (LLM, conf=0.92)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“a meta-analysis of 6 RCTs, recruiting 639 patients, reported a RR of remaining symptomatic of 0.73 (95% CI 0.55 to 0.97) compared with education and/or support and 0.67 (95% CI 0.49 to 0.91) compared with a waiting list control (online supplemental figure 20).156”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Partly supportedcites [156] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirectn = 639- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Adverse events were significantly more frequent with plecanatide 3 μg once a day, compared with placebo, and diarrhoea was significantly more likely with both doses.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Partly supportedcites [155] sourceExperimental — accuracy not yet measured
The Safety section (p. 19) reports significantly more overall adverse events with plecanatide 3 mg once daily than with placebo. It also reports that both plecanatide doses were significantly more likely to cause diarrhea than placebo (p. 20). The claim gives the 3 mg dose as 3 μg, a 1,000-fold difference. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“and an increase of ≥1 CSBMs per week from baseline (online supplemental figure 16).”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Supportedcites [155] source
The Data Extraction section (p. 12) defines CSBM response as an increase of at least one CSBM per week from baseline for at least 50% of weeks. The results (p. 18) report that tenapanor 50 mg twice daily was significantly more effective than placebo for CSBM response. (LLM, conf=0.92)
plaindirect- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Early reports of clinical outcomes via videoconsultation are also promising, with similar response rates achieved, compared with face-to-face treatment.259”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Supportedcites [259] source
The Results section reports a 65% response rate for Skype hypnotherapy versus 76% for face-to-face treatment, with no statistically significant difference after age adjustment. The Discussion calls the results encouraging while noting that Skype treatment might be marginally less effective. The comparison concerns hypnotherapy for irritable bowel syndrome. (LLM, conf=0.88)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“However, intervention with gut-focused hypnotherapy has been shown to have wider socioeconomic benefits including improving general well-being, reductions in healthcare utilisation in both primary and secondary care, [254][255][256] reduced presenteeism at work, 255 improved quality of life 252 257 and long-term beneficial effects on symptoms, 256”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Not checked — no full text of the sourcecites [254] source
- Not checked — no full text of the sourcecites [255] Houghton, 1996, Symptomatology, quality of life and economic features of irritable bowel syndrome--the effect of hypnotherapy, Aliment Pharmacol Ther source
- Supportedcites [256] source
Citation 256 is attached to reduced healthcare use and long-term symptom benefits, not to the separate presenteeism claim. The Consultation rates section reports that patients saw their GP and hospital consultant less often after hypnotherapy; the Abstract and Discussion report sustained symptom improvement for at least five years. The paper also reports improvements in well-being and quality of life. (LLM, conf=0.93)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“IBS research is leading the way in this regard with the first UK interventional virtual trial being conducted in IBS, demonstrating that virtual recruitment methods outperform site-dependent recruitment significantly.295 299”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > RESEARCH: BARRIERS, PRIORITIES AND IMPLICATIONS FOR FUTURE STUDY DESIGN
What the sources say
- Partly supportedcites [295] Kemppinen, 2020, Randomised, double-blind, placebo controlled multi-centre study to assess the efficacy, tolerability and safety of Enterosgel® in the treatment of irritable bowel syndrome with diarrhoea (IBS-D) in adults, Trials sourceExperimental — accuracy not yet measured
The Methods/design > Recruitment section describes an IBS-D interventional trial in England that uses a website and registry alongside recruitment through approximately 30 clinical sites (page not specified). It does not identify the study as the first UK interventional virtual trial or report a comparison showing that virtual recruitment significantly outperformed site-dependent recruitment. (LLM, conf=0.87)
- Not matchedcites [299] Virtual trial recruits 67% faster led by NIHR Patient Recruitment Centre in Newcastle in collaboration with Enteromed, 2020. Available: https://www.nihr.ac.uk/news/virtual-trial-recruits-67-faster-led-by-nihr-patient-recruitment-centre-in-newcastle-in-collaboration-with-enteromed/26290
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The drug was welltolerated, with diarrhoea the most common side effect, and there were no cardiovascular adverse events.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs in development
What the sources say
- Not checked — no full text of the sourcecites [179] source
- Partly supportedcites [180] sourceExperimental — accuracy not yet measured
The Discussion says minesapride was well tolerated, and the Results > Safety identifies diarrhoea as the most common treatment-emergent adverse event. But the Results > Safety also reports tachycardia in a patient taking 40 mg, leading to discontinuation, so the statement that there were no cardiovascular adverse events is not supported. (LLM, conf=0.92)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Among individuals who believe themselves to have IBS, only around 60% fulfil Rome IV criteria, whereas 80% fulfil Rome III.23”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > RESEARCH: BARRIERS, PRIORITIES AND IMPLICATIONS FOR FUTURE STUDY DESIGN
What the sources say
- Supportedcites [23] source
The Results section ('Proportion of Individuals with IBS Meeting the Rome III and Rome IV Criteria and Level of Agreement') reports that 59.1% of self-identified IBS respondents with complete Rome IV data met those criteria, while 78.9% with complete Rome III data met Rome III criteria. The Discussion likewise summarizes these figures as 60% and almost 80% among people who believe they have IBS. (LLM, conf=0.95)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Furthermore, patients are at increased risk of iatrogenic harms, through unnecessary surgery, including hysterectomy, appendicectomy and cholecystectomy, 121 and inappropriate prescribing of opioids.90”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Guidelines
What the sources say
- Supportedcites [121] source
Citation 121 is attached to the surgery claim, not the separate opioid-prescribing claim cited to 90. The Discussion reports increased rates of cholecystectomy, appendectomy and hysterectomy in patients with IBS and explicitly describes a risk of unnecessary surgery for all three (page not supplied). (LLM, conf=0.93)
- Supportedcites [90] Black, 2020, Functional gastrointestinal disorders: advances in understanding and management, The Lancet source
The citation to this source is attached to the surgery clause, not the separate opioid-prescribing clause. In Natural History and Effect, the paper reports higher rates of cholecystectomy, appendicectomy, and hysterectomy among people with IBS than among those without IBS; it also describes unnecessary surgery for FGID symptoms. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Current treatments for IBS are often inadequate and many patients remain unsatisfied with medical care.91 92 95”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > RESEARCH: BARRIERS, PRIORITIES AND IMPLICATIONS FOR FUTURE STUDY DESIGN
What the sources say
- Not checked — no full text of the sourcecites [91] source
- Not checked — no full text of the sourcecites [92] Bertram, 2001, The patient’s perspective of irritable bowel syndrome, J Fam Pract
- Supportedcites [95] source
The Introduction says effective treatment options for IBS are lacking. In “Impact on health service use,” most participants reported alienation from health services, including poor relationships with doctors and a belief that the NHS could offer no help for IBS. These passages support both parts of the claim. (LLM, conf=0.91)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“An RCT of delayed-release linaclotide, with action confined to the ileo-caecal region of the gastrointestinal tract, demonstrated significant effects on abdominal pain, with lower rates of diarrhoea than conventionrelease linaclotide.165”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs in development
What the sources say
- Partly supportedcites [165] sourceExperimental — accuracy not yet measured
The Introduction (page unavailable) says MD-7246 was designed to release at the ileocecal junction and cecum, but does not establish that its action was confined there. The Results (page unavailable) report modest abdominal-pain improvement with MD-7246, without a statistically significant effect versus placebo; the significant pain result was for DR1, which targets the ileum. The Safety results report lower diarrhea rates with MD-7246 than with immediate-release linaclotide. (LLM, conf=0.88)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Peppermint oil may be an effective treatment for global symptoms and abdominal pain in IBS.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > First-line treatments
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Loperamide may be an effective treatment for diarrhoea in IBS.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > First-line treatments
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Soluble fibre, such as ispaghula, is an effective treatment for global symptoms and abdominal pain in IBS, but insoluble fibre (eg, wheat bran) should be avoided as it may exacerbate symptoms.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > First-line treatments
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The non-absorbable antibiotic rifaximin is an efficacious second-line drug for IBS with diarrhoea in secondary care, although its effect on abdominal pain is limited.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, studies do not distinguish between affective, cognitive and true peripheral, versus central, mechanisms of visceral hypersensitivity.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Altered visceral perception
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Tegaserod, a 5-Hydroxytryptamine 4 receptor agonist, is an efficacious second-line drug for IBS with constipation in secondary care but is unavailable outside the USA.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Second-line treatments
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Interestingly, those studies that compared the low FODMAP diet with traditional dietary advice from NICE and the BDA had the least heterogeneity, but also the least magnitude of effect (RR 0.82; 95% CI 0.67 to 1.01), suggesting that the 50%-70% symptomatic benefit reported for a low FODMAP diet in some studies may have been overestimated.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“In one trial, there was no significant effect on either abdominal pain or number of bowel movements, 221 and in the second the number of bowel movements increased significantly, but with no improvement in abdominal pain.222”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
plainn = 181- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Polyethylene glycol was generally well-tolerated with abdominal pain the most frequent adverse event.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
plainn = 181- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Blurred vision, dizziness and altered sensation were more common with pregabalin.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
What the sources say
- Not checked — no full text of the sourcecites [228] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In this RCT, patients received open-label rifaximin and were then randomised to two repeat 14-day courses of rifaximin or placebo if they experienced symptom relapse.Significantly more patients experienced an improvement in global symptoms with rifaximin after each treatment course, and there were no safety concerns.238”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Not checked — no full text of the sourcecites [238] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A subsequent RCT of 12 mg once a day of bimodal release ondansetron also demonstrated superiority over placebo for improvement in stool consistency, but not abdominal pain.178”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
What the sources say
- Not checked — no full text of the sourcecites [178] source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Each section lead performed a comprehensive literature search, except for the section dealing with treatment, which was informed by a systematic review of the literature, the methodology for which is reported within that section.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Methodology
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In the absence of any biomarker being available for IBS, the condition is diagnosed using a positive approach, based on the clinical history.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLASSIFICATION AND DIAGNOSTIC CRITERIA
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The autonomic nervous system mediates communication between the gut and brain.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Central nervous system and autonomic nervous system modulation
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“In the latter instance, IBS is chronic, with fluctuating symptoms, in the majority of patients.12”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > EPIDEMIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [12] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In IBS, a reduction in parasympathetic activity and an increase in sympathetic nervous system activity is frequently observed.39”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Central nervous system and autonomic nervous system modulation
What the sources say
- Not checked — no full text of the sourcecites [39] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Conversely, the vagus nerve may sense the gut microenvironment indirectly and transfer this information to the brain.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Central nervous system and autonomic nervous system modulation
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moving from Rome III to Rome IV IBS may therefore reduce the likelihood of novel pharmacological therapies demonstrating efficacy in future randomised controlled trials (RCTs), due to the spectrum of symptom severity, or may mean that trials need to be considerably larger, and therefore more expensive to conduct, to show a beneficial effect.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Guidelines
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The pathophysiology of IBS is complex and remains poorly understood. 2”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > PATHOPHYSIOLOGY
What the sources say
- Not checked — no full text of the sourcecites [2] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“In both meta-analyses, heterogeneity between studies was substantial, presumably relating to differences in methodology, demographic characteristics of participants, cultural issues or a combination of these factors.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > EPIDEMIOLOGY
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The presence of abdominal pain at the required frequency distinguishes IBS from the other functional bowel disorders, which consist of functional constipation, functional diarrhoea and functional abdominal bloating or distension. 2”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLASSIFICATION AND DIAGNOSTIC CRITERIA
What the sources say
- Not checked — no full text of the sourcecites [2] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This more restrictive nature of the Rome IV criteria calls into question whether they should be used to diagnose IBS in clinical practice, and a more pragmatic definition of the symptoms that constitute IBS may be preferred.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLASSIFICATION AND DIAGNOSTIC CRITERIA
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
In the paper
“Colonic transit is abnormal in only 10%-20% of patients with IBS-C and IBS-M, and 25%-45% of patients with IBS-D.44 45”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Transit and motility
What the sources say
- Not matchedcites 44 45
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Establishing an effective doctor-patient relationship and a shared understanding is key to the successful diagnosis and management of chronic conditions such as IBS.89 90”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Doctor-patient communication and patient perspectives in primary care
What the sources say
- Not matchedcites 89 90
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
In the paper
“The expression and levels of the tight junction protein zonula occludens are significantly reduced in IBS-D, and associated with mast cell activation and symptoms.66”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
- Not checked — no full text of the sourcecites [66] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Their applicability to clinical practice has been challenged as unnecessarily restrictive, 98 and only a minority of people diagnosed with IBS in primary care fulfil them.99”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Diagnosis of IBS in primary care
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Increased permeability in patients with PI-IBS and IBS-D correlates with visceral sensitivity 60 61 and symptom severity.62 63”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Immune regulation, inflammation and epithelial permeability
What the sources say
- Not matchedcites 60 61
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites 62 63
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Moreover, changes in the gut microbiome can modify gastrointestinal motility, visceral sensation, intestinal permeability, stool consistency and visceral sensitivity.71 72”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > The microbiome
What the sources say
- Not matchedcites 71 72
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“The non-invasive marker of intestinal inflammation faecal calprotectin has enabled risk stratification to prioritise access to investigations to exclude IBD in patients with chronic diarrhoea, reducing unnecessary investigations and referrals from primary to secondary care.103”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigation in primary care
What the sources say
- Not matchedcites [103] The new faecal calprotectin care pathway, 2018. Available: https://wwwniceorguk/sharedlearning/the-new-faecal-calprotectin-care-pathway
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“the gold standard symptombased diagnostic criteria for IBS, the Rome criteria, are now in their fourth iteration.2”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > INTRODUCTION Aims
What the sources say
- Not checked — no full text of the sourcecites [2] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The Rome diagnostic criteria are based on specific symptoms of a defined duration and frequency, 2 which have been derived predominantly from secondary care patients, and are rarely used in primary care.97”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Diagnosis of IBS in primary care
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Patients with IBS-C display reduced motility, fewer high amplitude propagating contractions of the colon and delayed transit, whereas those with IBS-D have increased motility, more high amplitude propagating contractions and accelerated transit. 1”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Transit and motility
What the sources say
- Not checked — no full text of the sourcecites [1] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“They often feel their symptoms are dismissed or trivialised, describe the diagnostic process as confusing, or invasive, and the often-lengthy search for efficacious treatments as frustrating.87 89 91 -95”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Doctor-patient communication and patient perspectives in primary care
What the sources say
- Not matchedcites 87 89 91 -95
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Hence, most patients with IBS are keen to explore dietary options, with over 60% wanting to know what food(s) they should avoid, and up to 70% having modified their diet.192”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Fibre and dietary therapies
What the sources say
- Not checked — no full text of the sourcecites [192] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Coexistent early satiety, postprandial fullness, epigastric pain, nausea or heartburn are common, as functional dyspepsia and gastro-oesophageal reflux frequently overlap with IBS.[115][116][117]”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLINICAL HISTORY AND INVESTIGATION IN SECONDARY CARE The first consultation in secondary care
What the sources say
- Not matchedcites [115][116][117]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Extraintestinal symptoms, such as back pain, bladder and gynaecological symptoms, and insomnia are frequent, as is the presence of other functional somatic disorders, such as fibromyalgia, tension headache or chronic fatigue.118”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > CLINICAL HISTORY AND INVESTIGATION IN SECONDARY CARE The first consultation in secondary care
What the sources say
- Not checked — no full text of the sourcecites [118] Petersen, 2020, The unifying diagnostic construct of bodily distress syndrome (BDS) was confirmed in the general population, J Psychosom Res source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“IBS is not associated with an increased risk of cancer or mortality, 149 but affects quality of life to the same degree as organic gastrointestinal diseases, such as IBD. 13”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Communicating a positive diagnosis and management plan in secondary care
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Local laboratory values vary but, generally, a faecal calprotectin of <100 μg/g can be considered normal, 100-249 μg/g is borderline and should be repeated, with subsequent referral if persistently elevated, and ≥250 μg/g requires urgent referral to secondary care to exclude IBD.103”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigation in primary care
What the sources say
- Not matchedcites [103] The new faecal calprotectin care pathway, 2018. Available: https://wwwniceorguk/sharedlearning/the-new-faecal-calprotectin-care-pathway
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Not matched
In the paper
“Factors that should alert the clinician to the possibility of microscopic colitis include female sex, age ≥50 years, coexistent autoimmune disease, nocturnal or severe, watery, diarrhoea, duration of diarrhoea <12 months, weight loss or use of potential precipitating drugs including NSAIDs, PPIs, selective serotonin reuptake inhibitors (SSRIs) or statins.[127][128][129]”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Investigations in secondary care
What the sources say
- Not matchedcites [127][128][129]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, most trials recruited unselected patients with IBS, so whether the proposed reduc- tion in gastrointestinal motility with antispasmodics improves diarrhoea is unclear.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, these findings should be interpreted with caution, given heterogeneity between trial results and the varying end points studied.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, low study quality, the lack of consistent use of the Rome criteria to define IBS and heterogeneity between RCTs limit confidence in the data.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
plaincorrelationaln = 823- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although not completely understood, its putative antispasmodic action is via L-menthol's blockade of calcium channels.218”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Not checked — no full text of the sourcecites [218] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Current NICE guidance for the management of IBS suggests that patients with IBS-C can be treated with laxatives, advising dose titration according to symptoms.10”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
What the sources say
- Not checked — no full text of the sourcecites [10] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Loperamide is a synthetic μ-opioid agonist that reduces myenteric plexus activity, thereby increasing intestinal transit time and enhancing water reabsorption.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The long-term efficacy of osmotic laxatives in IBS-C is unknown, as both trials were of only 4 weeks duration.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used first line for IBS
plainn = 181- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Probiotics, as a group, may be an effective treatment for global symptoms and abdominal pain in IBS, but it is not possible to recommend a specific species or strain.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Recommendations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Due to the modest efficacy, and concerns over the potential for adverse events (including Clostridium difficile infection and bacterial resistance) with repeated courses of rifaximin, FDA approval was not forthcoming.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Patients with IBS often have comorbid anxiety and depression, 119 and these are also risk factors for the subsequent development of IBS in healthy people.31”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“There have been no RCTs of SNRIs in IBS, although there is evidence from case series that duloxetine may improve symptoms and quality of life, 224 225 and there is good evidence for use of SNRIs in other chronic painful disorders, such as fibromyalgia and low back pain.226”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Gut-brain neuromodulators
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although licensed for IBS-D, the drug is unavailable in many countries.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The drug is now licensed for IBS-D in the USA but is not available for this indication in many countries.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-D
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is likely that these approaches have similar efficacy, but more work is needed to determine cost-effectiveness of the various modes of delivery.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In one European study, approximately one in four individuals with IBS were categorised as severe in a general population setting.266”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Approach to the patient with severe or refractory symptoms
What the sources say
- Not checked — no full text of the sourcecites [266] Manzoli, 2017, Prevalence of severe irritable bowel syndrome among Italian adults, A meta-analysis. Eur Rev Med Pharmacol Sci source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Diarrhoea was the most common adverse event and was significantly more likely than with placebo.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs used second line for the treatment of IBS-C
What the sources say
- Not checked — no full text of the sourcecites [163] source
plaindirectn = 9,242- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although the risk of missing, or subsequently developing, an organic disorder in patients diagnosed with IBS is low, this rate may be increased in those with severe symptoms, 267”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Approach to the patient with severe or refractory symptoms
What the sources say
- Not checked — no full text of the sourcecites [267] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These data suggest that treatment with IBS-specific CBT protocols may benefit both mental health and gastrointestinal symptoms.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There were also significant improvements in extraintestinal symptoms, and anxiety and depression scores.252”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
What the sources say
- Not checked — no full text of the sourcecites [252] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Evidence suggests, therefore, that CBT for IBS is effective in both high-intensity (therapist-delivered) and minimal contact (therapist-guided) formats, as well as self-administered with either bibliographic material or web-based.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Psychological therapies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The cannabinoid type-2 receptor agonist, olorinab, has been tested in patients with quiescent Crohn's disease, and led to reductions in abdominal pain and improved bowel movements 293”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Drugs in development
What the sources say
- Not checked — no full text of the sourcecites [293] Yacyshyn, 2019, Su1930 – Safety and Efficacy of Olorinab, a Peripherally Restricted, Highly Selective, Cannabinoid Receptor 2 Agonist in a Phase 2A Study in Chronic Abdominal Pain Associated with Crohn’s Disease, Gastroenterology source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This would allow faster recruitment to RCTs, provide equity of access for patients and give a better indication of the true benefit of treatments being studied in the population most likely to use them.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > RESEARCH: BARRIERS, PRIORITIES AND IMPLICATIONS FOR FUTURE STUDY DESIGN
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
- Rests on an assumption: There are often severity criteria built in, which aim to exclude the most severe or refractory symptoms, as well as less severe cases.
- Rests on an assumption: Many treatments are restricted to patients with IBS-C or IBS-D, whereas those with IBS-M or IBS-U are rarely recruited.
- Rests on an assumption: Although there are established composite end points for IBS-C and IBS-D, these do not exist for IBS-M or IBS-U.
- Rests on an assumption: Recruitment to trials is optimal when patients are linked to specialist clinics.
- Rests on an assumption: Patients with IBS are widely disseminated, mostly in community care, often with no long-term follow-up, and only a minority attend specialist clinics where research is undertaken.
- Rests on an assumption: The latter group (specialist clinic patients) is often more complex, more refractory and, by definition, less appropriate for treatment trials.
- Rests on an assumption: There are often too many visits, a need for invasive investigations, and a high burden of data collection.
- Rests on an assumption: Patients who enter IBS trials have usually tried all available treatments and remain unsatisfied with care, so being randomised to 'standard care' for ≥12 weeks is unappealing.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Nevertheless, it is important to stress that in most patients a diagnosis of IBS is secure, 111 and further repeated investigations have a low yield.268”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Approach to the patient with severe or refractory symptoms
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although RCTs remain the gold standard, they have many weaknesses, and modern methods of trial design may be more suitable to studying IBS.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > RESEARCH: BARRIERS, PRIORITIES AND IMPLICATIONS FOR FUTURE STUDY DESIGN
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
- Rests on an assumption: There are often severity criteria built in, which aim to exclude the most severe or refractory symptoms, as well as less severe cases.
- Rests on an assumption: Many treatments are restricted to patients with IBS-C or IBS-D, whereas those with IBS-M or IBS-U are rarely recruited.
- Rests on an assumption: Although there are established composite end points for IBS-C and IBS-D, these do not exist for IBS-M or IBS-U.
- Rests on an assumption: Recruitment to trials is optimal when patients are linked to specialist clinics.
- Rests on an assumption: Patients with IBS are widely disseminated, mostly in community care, often with no long-term follow-up, and only a minority attend specialist clinics where research is undertaken.
- Rests on an assumption: The latter group (specialist clinic patients) is often more complex, more refractory and, by definition, less appropriate for treatment trials.
- Rests on an assumption: There are often too many visits, a need for invasive investigations, and a high burden of data collection.
- Rests on an assumption: Patients who enter IBS trials have usually tried all available treatments and remain unsatisfied with care, so being randomised to 'standard care' for ≥12 weeks is unappealing.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite this, and the high prevalence of IBS, the pipeline of new treatments is relatively poor.”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > RESEARCH: BARRIERS, PRIORITIES AND IMPLICATIONS FOR FUTURE STUDY DESIGN
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“is a multifactorial disorder of gut-brain interaction”
§ British Society of Gastroenterology guidelines on the management of irritable bowel syndrome > Additional information
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper relies on this without support.
The evidence from clinical trials and meta-analyses is applicable to the general IBS population in clinical practice.
“The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based management of patients.”
The paper relies on this without support.
The recommendations will lead to improved patient outcomes.
“providing a practical framework for evidence-based management of patients.”
The paper relies on this without support.
The quality of evidence grading accurately reflects the certainty of the evidence.
“Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system, summarising both the strength of the recommendations and the overall quality of evidence.”
The paper relies on this without support.
The main pathophysiological aspect of IBS is related to visceral hypersensitivity, which is also the principal target of many current treatments.
“The main pathophysiological aspect is related to visceral hypersensitivity, which is also the principal target of many current treatments.”
The paper relies on this without support.
IBS is a disorder of gut-brain interaction.
“explaining IBS as a disorder of gut-brain interaction”
The paper relies on this without support.
Cure is unlikely, but substantial improvement in symptoms, social functioning and quality of life is achievable.
“It is important to stress that cure is unlikely, but substantial improvement in symptoms, social functioning and quality of life is achievable.”
The paper relies on this without support.
Most second-line drugs are only available in secondary care.
“Most second-line drugs are only available in secondary care.”
The paper relies on this without support.
The treatment of IBS is generally directed towards the predominant symptom, or symptoms, experienced by the patient.
“The treatment of IBS is generally directed towards the predominant symptom, or symptoms, experienced by the patient.”
The paper relies on this without support.
Calprotectin is not specific to IBD and can be elevated in older age groups (age ≥45 years), obesity, infection, malignancy or by medications, such as proton pump inhibitors (PPIs) or non-steroidal anti-inflammatory drugs (NSAIDs).
“However, calprotectin is not specific to IBD and can be elevated in older age groups (age ≥45 years), obesity, infection, malignancy or by medications, such as proton pump inhibitors (PPIs) or non-steroidal anti-inflammatory drugs (NSAIDs).”
The paper relies on this without support.
The Rome IV criteria are the gold standard to define IBS for research purposes.
“Although the Rome IV criteria are the gold standard to define IBS for research purposes”
The authors state this as an assumption.
Some IBS symptoms are a result of gastrointestinal spasm and dysmotility, which antispasmodics ameliorate.
“The proposed mechanism of action of these agents is based on the assumption that some IBS symptoms are a result of gastrointestinal spasm and dysmotility, which antispasmodics ameliorate.217”
The paper relies on this without support.
In clinical practice, abdominal pain, bloating, nausea and constipation are common side effects of loperamide, and may limit tolerability.
“However, in clinical practice, abdominal pain, bloating, nausea and constipation are common side effects, and may limit tolerability.”
The paper relies on this without support.
Dysfunction within the bidirectional gut-brain axis plays an important role in the genesis and maintenance of symptoms in IBS.
“Dysfunction within the bidirectional gut-brain axis is considered to play an important role in the genesis and maintenance of symptoms in IBS.”
The paper relies on this without support.
There are often severity criteria built in, which aim to exclude the most severe or refractory symptoms, as well as less severe cases.
“There are often severity criteria built in, which aim to exclude the most severe or refractory symptoms, as well as less severe cases.”
The paper relies on this without support.
Many treatments are restricted to patients with IBS-C or IBS-D, whereas those with IBS-M or IBS-U are rarely recruited.
“many treatments are restricted to patients with IBS-C or IBS-D, whereas those with IBS-M or IBS-U are rarely recruited”
The paper relies on this without support.
Although there are established composite end points for IBS-C and IBS-D, these do not exist for IBS-M or IBS-U.
“although there are established composite end points for IBS-C and IBS-D, these do not exist for IBS-M or IBS-U”
The paper relies on this without support.
Recruitment to trials is optimal when patients are linked to specialist clinics.
“Second, recruitment to trials is optimal when patients are linked to specialist clinics.”
The paper relies on this without support.
Patients with IBS are widely disseminated, mostly in community care, often with no long-term follow-up, and only a minority attend specialist clinics where research is undertaken.
“However, patients with IBS are widely disseminated, mostly in community care, often with no long-term follow-up, and only a minority attend specialist clinics where research is undertaken.”
The paper relies on this without support.
The latter group (specialist clinic patients) is often more complex, more refractory and, by definition, less appropriate for treatment trials.
“This latter group is often more complex, more refractory and, by definition, less appropriate for treatment trials.”
The paper relies on this without support.
There are often too many visits, a need for invasive investigations, and a high burden of data collection.
“There are often too many visits, a need for invasive investigations, and a high burden of data collection.”
The paper relies on this without support.
Patients who enter IBS trials have usually tried all available treatments and remain unsatisfied with care, so being randomised to 'standard care' for ≥12 weeks is unappealing.
“Patients who enter IBS trials have usually tried all available treatments and remain unsatisfied with care, so being randomised to 'standard care' for ≥12 weeks is unappealing.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Some probiotics may be bene fi cial in irritable bowel syndrome (IBS), but differences in species and strains used, as well as endpoints reported, have hampered attempts to make speci fi c recommendations as to which should be preferred.”
From Efficacy of Probiotics in Irritable Bowel Syndrome: Systematic Review and Meta-analysis (2023) · cites this paper as [10]
Experimental — accuracy not yet measured
Citations
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Cited by
Sorted by citations
Black, C. J., Staudacher, H. M., & Ford, A. C. (2021) · Gut · doi:10.1136/gutjnl-2021-325214 · Cited by 380
Self-citationPeery, A. F., Kelly, C. R., Kao, D. H., Vaughn, B. P., Lebwohl, B., Singh, S. S., Imdad, A., & Altayar, O. (2024) · Gastroenterology · doi:10.1053/j.gastro.2024.01.008 · Cited by 299
Irritable bowel syndrome and mental health comorbidity — approach to multidisciplinary management
Staudacher, H. M., Black, C. J., Teasdale, S. B., Mikocka‐Walus, A. A., & Keefer, L. (2023) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-023-00794-z · Cited by 292
Self-citationSasso, J. M., Ammar, R. M., Tenchov, R., Lemmel, S. A., Kelber, O., Grieswelle, M., & Zhou, Q. A. (2023) · ACS Chemical Neuroscience · doi:10.1021/acschemneuro.3c00127 · Cited by 229
British Society of Gastroenterology guidelines on the management of functional dyspepsia
Black, C. J., Paine, P., Agrawal, A., Aziz, I., Eugenicos, M. P., Houghton, L. A., Hungin, P., Overshott, R., Vasant, D. H., Rudd, S., et al. (2022) · Gut · doi:10.1136/gutjnl-2022-327737 · Cited by 216
“166 Analysis of dietary data collected from more than 30 000 French adults found the consumption of ultraprocessed foods, which are high in saturated fat and additives, to be associated with FD, although this was only apparent when FD coexisted with IBS, rather than in those with FD alone.”
BackgroundInfluentialSelf-citation
Metadata
- Authors
- Vasant, D. H., Paine, P. A., Black, C. J., Houghton, L. A., Everitt, H. A., Corsetti, M., Agrawal, A., Aziz, I., Farmer, A. D., Eugenicos, M. P., Moss-Morris, R., Yiannakou, Y., & Ford, A. C.
- Affiliations
- University of Manchester (GB)
- Salford Royal NHS Foundation Trust (GB)
- University of Leeds (GB)
- University of Southampton (GB)
- University of Nottingham (GB)
- Bassetlaw Hospital (GB)
- Sheffield Teaching Hospitals NHS Foundation Trust (GB)
- University Hospitals of North Midlands NHS Trust (GB)
- Western General Hospital (GB)
- King's College London (GB)
- National Health Service (GB)
- Corresponding author
- Ford, Alexander C
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2021-04-26
- Volume
- 70
- Issue
- 7
- Pages
- 1214-1240
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W3159143441
- Cited by
- 592
- References
- 309
- Citations by year
- 2026: 138 · 2025: 135 · 2024: 107 · 2023: 105 · 2022: 80 · 2021: 25
- FWCI
- 56.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Repository@Nottingham (University of Nottingham) (acceptedVersion, other-oa)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by-nc)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- Nottingham University Hospitals NHS Trust
- National Institute for Health and Care Research (11/69/02)
- University of Nottingham
- NIHR Nottingham Biomedical Research Centre
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Health and Development
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- irritable bowel syndrome, gut-brain axis, IBS diagnosis, IBS management, dietary therapy, pharmacotherapy, psychotherapy, network meta-analysis, evidence-based recommendations
- MeSH terms
- Drug Development, Communication, Constipation, Diarrhea, Diet, United Kingdom, Humans, Hypnosis, Patient Education as Topic, Physician-Patient Relations, Serotonin Antagonists, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Probiotics, Biomedical Research, Irritable Bowel Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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