Clinical practice guidelines for irritable bowel syndrome in Korea, 2017 revised edition
Open accessAbstract
In 2011, the Korean Society of Neurogastroenterology and Motility (KSNM) published clinical practice guidelines on the management of irritable bowel syndrome (IBS) based on a systematic review of the literature. The KSNM planned to update the clinical practice guidelines to support primary physicians, reduce the socioeconomic burden of IBS, and reflect advances in the pathophysiology and management of IBS. The present revised version of the guidelines is in continuity with the previous version and targets adults diagnosed with, or suspected to have, IBS. A librarian created a literature search query, and a systematic review was conducted to identify candidate guidelines. Feasible documents were verified based on predetermined inclusion and exclusion criteria. The candidate seed guidelines were fully evaluated by the Guidelines Development Committee using the Appraisal of Guidelines for Research and Evaluation II quality assessment tool. After selecting 7 seed guidelines, the committee prepared evidence summaries to generate data exaction tables. These summaries comprised the 4 main themes of this version of the guidelines: colonoscopy; a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; probiotics; and rifaximin. To adopt the core recommendations of the guidelines, the Delphi technique (ie, a panel of experts on IBS) was used. To enhance dissemination of the clinical practice guidelines, a Korean version will be made available, and a food calendar for patients with IBS is produced.
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These guidelines discouraged consumption of insoluble fiber from sources such as beans, nuts, and grains [47] or whole grains [48], and they discouraged intake of foods with high oligosaccharide content (for example, legumes, chickpeas, and lentils [49]).
“These guidelines discouraged consumption of insoluble fiber from sources such as beans, nuts, and grains [47] or whole grains [48], and they discouraged intake of foods with high oligosaccharide content (for example, legumes, chickpeas, and lentils [49]).”
Six of the CPGs (55%) made food group recommendations, and just 3 food groups were mentioned by >1 CPG. These included fruit (27% encouraged), vegetables (27% encouraged), and legumes/pulses (9% encouraged; 18% discouraged, for populations with IBS [47,49]).
“Six of the CPGs (55%) made food group recommendations, and just 3 food groups were mentioned by >1 CPG. These included fruit (27% encouraged), vegetables (27% encouraged), and legumes/pulses (9% encouraged; 18% discouraged, for populations with IBS [47,49]).”
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BackgroundResultInfluentialA placebo-controlled trial of prucalopride for severe chronic constipation
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“Two placebo-controlled trials have assessed the efficacy of lubiprostone in IBS-C patients.(122,123) Interestingly, lubiprostone exerted a greater effect on abdominal pain and bowel movement than did the placebo.”
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“2 April, 2018 (197-215) pain or discomfort, but bran did not.(43) A recent meta-analysis of 14 RCTs found that soluble fiber such as ispaghula husk was better than placebo with respect to relieving the symptoms of IBS (relative risk [RR], 0.”
BackgroundLembo, A., Pimentel, M., Rao, S. S., Schoenfeld, P., Cash, B., Weinstock, L. B., Paterson, C., Bortey, E., & Forbes, W. P. (2016) · Gastroenterology · doi:10.1053/j.gastro.2016.08.003 · Cited by 310 · cited 1× · see citing works
“Journal of Neurogastroenterology and Motility while in 2 large RCTs, the patients took rifaximin 550 mg tid for 2 weeks.(94,95) Four RCTs with dichotomous endpoints support the efficacy of rifaximin in patients with IBS-D and those with relapsing symptoms of IBS-D, and repeat rifaximin treatment was efficacious and we…”
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“79 Prucalopride accelerates gastrointestinal and colonic transit in patients with constipation.(80) Prucalopride 2 mg once daily for 12 weeks was more efficacious than a placebo in improving stool frequency and stool consistency, decreasing the need for rescue medications and reducing symptoms of constipation in Asian…”
BackgroundIrritable bowel syndrome: a little understood organic bowel disease?
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Self-citationPredictive Value of The Rome Criteria for Diagnosing The Irritable Bowel Syndrome
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“Thus, these diagnostic tests should not be included in the routine evaluation of IBS, and testing should be individualized depending on factors such as age, sex, family history of gastrointestinal disease, presence of stress or other psychological factors, specific symptom predominance, symptom duration and severity,…”
BackgroundRole of loperamide and placebo in management of irritable bowel syndrome (IBS)
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“The starting dose of loperamide varies from 2 mg once daily to twice daily, and doses of up to 12 mg daily are reportedly safe.(60) Although the efficacy of as-needed loperamide for IBS has not been evaluated, it is commonly used in clinical practice.”
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“rhamnosus, Bifidobacterium breve, Bifidobacterium lactis, Bifidobacterium longum, and Streptococcus thermophiles) provided adequate relief of overall IBS symptoms and improved stool consistency in IBS-D patients but had no significant effect on individual symptoms.(107) Agents that restore the balance of the colonic m…”
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“SSRIs promote peristalsis and thus are considered to be more effective for IBS-C than IBS-D.(117) A recent study in Korea reported that the selective 5-HT reuptake enhancer tianeptine was not inferior to the TCA amitriptyline in providing global relief of IBS symptoms (abdominal pain/ discomfort, stool frequency/consi…”
BackgroundInfluentialEvidence-based clinical practice guidelines for irritable bowel syndrome
Fukudo, S., Kaneko, H., Akiho, H., Inamori, M., Endo, Y., Okumura, T., Kanazawa, M., Kamiya, T., Sato, K., Chiba, T., et al. (2014) · Journal of Gastroenterology · doi:10.1007/s00535-014-1017-0 · Cited by 207 · cited 1× · see citing works
“Although there is no clear evidence of the efficacy of other behavioral modifications, such as eliminating alcohol or smoking, getting good sleep, and taking rest, in reducing IBS symptoms, a reduction in the risk of IBS is plausible.(20) Physical activity and other behavioral modifications may be recommended for impr…”
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A Double-Blind Placebo-Controlled Trial with Loperamide in Irritable Bowel Syndrome
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“In the late 1980s, double-blinded RCTs revealed that loperamide improved stool consistency and frequency but not pain or global symptoms in IBS patients.(62,63) However, the overall quality of evidence was very low due to the small sample size, serious risk of bias, and imprecision.”
BackgroundClinical trial: phase 2 study of lubiprostone for irritable bowel syndrome with constipation
Johanson, J. F., Drossman, D. A., Panas, R. M., Wahle, A., & Ueno, R. (2008) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2008.03629.x · Cited by 205 · cited 2× · see citing works
“Two placebo-controlled trials have assessed the efficacy of lubiprostone in IBS-C patients.(122,123) Interestingly, lubiprostone exerted a greater effect on abdominal pain and bowel movement than did the placebo.”
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Cognitive therapy for irritable bowel syndrome.
Greene, B., & Blanchard, E. B. (1994) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.62.3.576 · Cited by 188 · cited 2× · see citing works
“In addition, conducting comparative or double-blinded trials of psychological therapies is difficult; therefore, we should pay much attention to when the results are directly applicable to the real clinical practice.(124) Cognitive behavioral therapy (NNT=3; 95% CI, 2-6), 124,129,130 dynamic psychotherapy (NNT=3.”
BackgroundFood Choice as a Key Management Strategy for Functional Gastrointestinal Symptoms
Gibson, P. R., & Shepherd, S. (2012) · The American Journal of Gastroenterology · doi:10.1038/ajg.2012.49 · Cited by 188 · see citing works
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Chapman, R. W., Stanghellini, V, Geraint, M., & Halphen, M. (2013) · American Journal of Gastroenterology · doi:10.1038/ajg.2013.197 · Cited by 180 · cited 12× · see citing works
“• Grade of recommendation: 1 • Level of evidence: B • Not voted in the revised edition Antispasmodics, including smooth muscle relaxants, antimuscarinic agents, anticholinergics, and calcium channel blockers, have long been used to treat IBS.”
BackgroundInfluentialLee, S. Y., Lee, K. J., Kim, S. J., & Cho, S. W. (2009) · Digestion · doi:10.1159/000211715 · Cited by 177 · see citing works
Loperamide in Treatment of Irritable Bowel Syndrome—A Double-Blind Placebo Controlled Study
Lavö, B., Stenstam, M., & Nielsen, A.-L. (1987) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528709091003 · Cited by 175 · see citing works
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Asian consensus on irritable bowel syndrome
Gwee, K., Bak, Y., Ghoshal, U. C., Gonlachanvit, S., Lee, O. Y., Fock, K. M., Chua, A. S. B., Lu, C., Goh, K., Kositchaiwat, C., et al. (2010) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2010.06353.x · Cited by 172 · see citing works
Diagnostic yield of alarm features in irritable bowel syndrome and functional dyspepsia
Hammer, J., Eslick, G. D., Howell, S. C., Altiparmak, E., & Talley, N. J. (2004) · Gut · doi:10.1136/gut.2003.021857 · Cited by 170 · cited 2× · see citing works
“However, certain “alarm signs” (unexplained weight loss, blood in the stool, anemia, and a recent change in bowel habits) call for special consideration of other disorders before symptoms can be attributed to IBS.(18,27,31,32) In these cases, colonoscopy has diagnostic value, not only for excluding organic diseases su…”
BackgroundBoyce, P. M., Talley, N. J., Balaam, B., Koloski, N. A., & Truman, G. (2003) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2003.07716.x · Cited by 167 · see citing works
Symptomatic overlap between irritable bowel syndrome and microscopic colitis
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“05).(111) However, another study reported that TCAs have similar efficacy against IBS D, IBS-C, and IBS-mixed.”
ResultDiagnosis of irritable bowel syndrome
Olden, K. W. (2002) · Gastroenterology · doi:10.1053/gast.2002.33741 · Cited by 152 · see citing works
Bove, A. (2012) · World Journal of Gastroenterology · doi:10.3748/wjg.v18.i36.4994 · Cited by 151 · see citing works
Loperamide Treatment of the Irritable Bowel Syndrome
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“In the late 1980s, double-blinded RCTs revealed that loperamide improved stool consistency and frequency but not pain or global symptoms in IBS patients.(62,63) However, the overall quality of evidence was very low due to the small sample size, serious risk of bias, and imprecision.”
BackgroundTwo controlled evaluations of multicomponent psychological treatment of irritable bowel syndrome
Blanchard, E. B., Schwarz, S. P., Suls, J. M., Gerardi, M. A., Scharff, L., Greene, B., Taylor, A. E., Berreman, C. F., & Malamood, H. S. (1992) · Behaviour Research and Therapy · doi:10.1016/0005-7967(92)90141-3 · Cited by 148 · see citing works
Irritable bowel syndrome in adults in primary care: summary of updated NICE guidance
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The treatment of irritable bowel syndrome with hypnotherapy
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“05).(106) A probiotic mixture (Lactobacillus acidophilus, L.”
Cognitive therapy for irritable bowel syndrome.
Greene, B., & Blanchard, E. B. (1994) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.62.3.576 · Cited by 140 · see citing works
Chang, L., Lembo, A. J., & Sultan, S. (2014) · Gastroenterology · doi:10.1053/j.gastro.2014.09.002 · Cited by 135 · cited 1× · see citing works
“The overall quality of rifaximin was rated as moderate.(96) In contrast to other treatments for IBS, which were taken daily, rifaximin was administered for a short duration.”
Laird, K. T., Tanner-Smith, E. E., Russell, A. C., Hollon, S. D., & Walker, L. S. (2016) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2015.11.020 · Cited by 135 · cited 2× · see citing works
“A recent meta-analysis of 41 trials involving 2290 patients reported that psychological therapies reduce gastrointestinal symptoms in patients with IBS at 1-6 months and 6-12 months after treatment.(131) However, these studies had limitations, including a low methodological quality, relatively few patients, and no con…”
BackgroundRole of antispasmodics in the treatment of irritable bowel syndrome
Annaházi, A. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i20.6031 · Cited by 134 · cited 1× · see citing works
“In a meta-analysis, antispasmodics showed a beneficial effect on abdominal pain, global symptom assessment, and symptom scores.(49,52) The results of RCTs of antispasmodics are summarized in Table 3.”
BackgroundHoughton, Foster, & Whorwell (2000) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2000.00762.x · Cited by 132 · cited 1× · see citing works
“5-HT3 receptors play an important role in visceral pain, and 5-HT3 receptor antagonists decrease painful sensations from the gut and slow intestinal transit.(65,66) 5-HT3 receptor antagonists reportedly slow colonic transit, blunt the gastrocolonic reflex, and reduce rectal sensitivity and postprandial motility,(66,67…”
BackgroundJung, H., Choung, R. S., Locke, R. G., Schleck, C. D., Zinsmeister, A. R., & Talley, N. J. (2009) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.621 · Cited by 128 · cited 1× · see citing works
“The diagnostic yield of colonoscopy among IBS patients is very low.(29,30) However, certain “alarm signs” (unexplained weight loss, blood in the stool, anemia, and a recent change in bowel habits) call for special consideration of other disorders before symptoms can be attributed to IBS.”
BackgroundFukudo, S., Kinoshita, Y., Okumura, T., Ida, M., Akiho, H., Nakashima, Y., Nishida, A., & Haruma, K. (2016) · Gastroenterology · doi:10.1053/j.gastro.2015.10.047 · Cited by 125 · see citing works
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Evaluation of patients who meet clinical criteria for irritable bowel syndrome.
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Self-management for women with irritable bowel syndrome
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Daley, A., Grimmett, C., Roberts, L., Wilson, S., Fatek, M., Roalfe, A., & Singh, S. (2008) · International Journal of Sports Medicine · doi:10.1055/s-2008-1038600 · Cited by 118 · see citing works
Utility of red flag symptom exclusions in the diagnosis of irritable bowel syndrome
WHITEHEAD, W. E., PALSSON, O. S., FELD, A. D., LEVY, R. L., VON KORFF, M., TURNER, M. J., & DROSSMAN, D. A. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.02956.x · Cited by 118 · cited 12× · see citing works
“• Grade of recommendation: 1 • Level of evidence: B • Not voted in the revised edition Antispasmodics, including smooth muscle relaxants, antimuscarinic agents, anticholinergics, and calcium channel blockers, have long been used to treat IBS.”
BackgroundInfluentialClavé, P., Acalovschi, M., Triantafillidis, J. K., Uspensky, Y. P., Kalaycı, C., Shee, V., Tack, J. F., & on behalf of the OBIS Study Investigators (2011) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2011.04730.x · Cited by 113 · cited 1× · see citing works
“fective in reducing pain and improving defecation alterations in IBS patients in placebo-controlled trials.(56) Pinaverium bromide has been used to manage the symptoms of IBS.”
MethodSimrén, M., Ringström, G., Björnsson, E. S., & Abrahamsson, H. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000116964.76529.6e · Cited by 111 · see citing works
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“No serious adverse events were reported.(59)”
Ke, M., Zou, D., Yuan, Y., Li, Y., Lin, L., Hao, J., Hou, X., & Kim, H. J. (2012) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2012.01983.x · Cited by 107 · see citing works
Self-citationBran supplementation in the treatment of irritable bowel sgndrome
Snook, J. A., & Shepherd, H. A. (1994) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.1994.tb00323.x · Cited by 107 · cited 1× · see citing works
“Bulking agents can cause bloating, gas, and abdominal discomfort or pain in some IBS patients.(45)”
BackgroundXie, C., Tang, Y., Wang, Y., Yu, T., Wang, Y., Jiang, L., & Lin, L. (2015) · PLoS ONE · doi:10.1371/journal.pone.0127815 · Cited by 106 · cited 3× · see citing works
“77).(116) Indeed, in a subgroup analysis, TCAs (n = 428) improved the global symptoms of IBS (RR, 1.”
BackgroundInfluentialWeinberg, D. S., Smalley, W. E., Heidelbaugh, J. J., & Sultan, S. (2014) · Gastroenterology · doi:10.1053/j.gastro.2014.09.001 · Cited by 102 · see citing works
The Effect of Trimipramine in Patients with the Irritable Bowel Syndrome
Myren, J., Groth, H., Larssen, S.-E., Larsen, S., & The Multicentre Study Group (1982) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528209181108 · Cited by 101 · see citing works
Fukudo, S., Ida, M., Akiho, H., Nakashima, Y., & Matsueda, K. (2013) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2013.11.024 · Cited by 95 · see citing works
Goldberg, P. A., Kamm, M. A., Setti-Carraro, P., van der Sijp, J. R. M., & Roth, C. (2009) · Digestion · doi:10.1159/000201377 · Cited by 95 · cited 1× · see citing works
“5-HT3 receptors play an important role in visceral pain, and 5-HT3 receptor antagonists decrease painful sensations from the gut and slow intestinal transit.(65,66) 5-HT3 receptor antagonists reportedly slow colonic transit, blunt the gastrocolonic reflex, and reduce rectal sensitivity and postprandial motility,(66,67…”
BackgroundZheng, Y., Yu, T., Tang, Y., Xiong, W., Shen, X., Jiang, L., & Lin, L. (2017) · PLoS ONE · doi:10.1371/journal.pone.0172846 · Cited by 92 · cited 6× · see citing works
“Ramosetron is a novel potent and selective 5-HT3 receptor antagonist, which is reportedly useful in patients with IBS-D.(68) Table 3.”
BackgroundInfluentialA systematic review of efficacy and tolerability of mebeverine in irritable bowel syndrome
Darvish-Damavandi, M. (2010) · World Journal of Gastroenterology · doi:10.3748/wjg.v16.i5.547 · Cited by 89 · cited 1× · see citing works
“However, in a recent systematic review of 8 RCTs, mebeverine treatment did not result in significant clinical improvement or relief of abdominal pain compared with a placebo.(54,55) Otilonium bromide is a poorly absorbed antispasmodic agent found to be ef-”
BackgroundMatsueda, K., Harasawa, S., Hongo, M., Hiwatashi, N., & Sasaki, D. (2008) · Digestion · doi:10.1159/000150632 · Cited by 87 · see citing works
Everitt, H., Moss-Morris, R. E., Sibelli, A., Tapp, L., Coleman, N. S., Yardley, L., Smith, P. W. F., & Little, P. S. (2013) · BMC Gastroenterology · doi:10.1186/1471-230x-13-68 · Cited by 83 · cited 1× · see citing works
“However, in a recent systematic review of 8 RCTs, mebeverine treatment did not result in significant clinical improvement or relief of abdominal pain compared with a placebo.(54,55) Otilonium bromide is a poorly absorbed antispasmodic agent found to be ef-”
BackgroundPrevalence of irritable bowel syndrome in Japan: Internet survey using Rome III criteria.
Miwa, H. (2008) · PubMed · Cited by 81 · see citing works
Lembo, A., Zakko, S. F., Ferreira, N. L., Ringel, Y., Bortey, E., Courtney, K., Corsi, E., Forbes, W. P., & Pimentel, M. (2008) · Gastroenterology · doi:10.1016/s0016-5085(08)62544-5 · Cited by 77 · see citing works
Wittmann, T., Paradowski, L., Ducrotte, P. R., Bueno, L. P., & Andro-Delestrain, M.-C. (2010) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2009.04216.x · Cited by 74 · cited 1× · see citing works
“Alverine, in combination with simethicone, resulted in a significant reduction in abdominal pain and discomfort in a large placebo-controlled trial.(53) Mebeverine is a musculotropic agent with antispasmodic activity that regulates bowel function.”
BackgroundHalpert, A. D., Dalton, C. B., Diamant, N. E., Toner, B. B., Hu, Y., Morris, C. B., Bangdiwala, S. I., Whitehead, W. E., & Drossman, D. A. (2005) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2005.30375.x · Cited by 73 · cited 1× · see citing works
“However, another study reported that TCAs have similar efficacy against IBS D, IBS-C, and IBS-mixed.(118) Further largescale studies of the clinical effects of antidepressants in IBS patients are thus needed.”
ResultBallou, S., & Keefer, L. (2016) · Neurogastroenterology & Motility · doi:10.1111/nmo.12982 · Cited by 72 · cited 1× · see citing works
“IBS patients are more likely to suffer from psychiatric diseases, including anxiety and depression, than are healthy individuals.(1) Besides these psychiatric comorbidities, IBS per se impairs the daily functioning of patients.”
BackgroundLee, K. J., Kim, N. Y., Kwon, J. K., Huh, K. C., Lee, O. Y., Lee, J. S., Choi, S. C., Sohn, C. I., Myung, S., Park, H., et al. (2011) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2011.01771.x · Cited by 71 · see citing works
Zheng, L., Lai, Y., Lu, W., Li, B., Fan, H., Yan, Z., Gong, C., Wan, X., Wu, J., Huang, D., et al. (2015) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2015.01.015 · Cited by 71 · see citing works
Systematic review and meta analysis: polyethylene glycol in adults with non-organic constipation
Belsey, J., Geraint, M., & Dixon, T. A. (2010) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2010.02397.x · Cited by 70 · cited 1× · see citing works
“A meta-analysis reported that PEG significantly increased the number of stools per week in patients with chronic constipation.(46) However, PEG has not been extensively evaluated in patients with IBS-C.”
BackgroundThe Low FODMAP Diet and Its Application in East and Southeast Asia
Iacovou, M., Tan, V. P. Y., Muir, J. G., & Gibson, P. R. (2015) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm15111 · Cited by 69 · cited 2× · see citing works
“East and Southeast Asian foods high in FODMAPs include Korean foods (kimchi, doenjang, ssamjang, and mandu), Japanese foods (gyozas), Thai foods (tom yum soup and some curry paste), Chinese foods (dim sum, wonton, man tou, red been sweet soup, and green bean soup), and Vietnamese foods (pho topped with onion).(37,40)”
BackgroundMedication Management of Irritable Bowel Syndrome
Trinkley, K. E., & Nahata, M. C. (2014) · Digestion · doi:10.1159/000362405 · Cited by 68 · cited 1× · see citing works
“The adverse events of loperamide were similar to those of placebo; however, nausea, cramping, and constipation frequently occur in the general population.(64)”
BackgroundReview: The treatment of irritable bowel syndrome
Lacy, B. E., Weiser, K., & Lee, R. D. (2009) · Therapeutic Advances in Gastroenterology · doi:10.1177/1756283x09104794 · Cited by 66 · see citing works
Biomarkers of Irritable Bowel Syndrome
Kim, J. H., Lin, E. A., & Pimentel, M. (2016) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm16135 · Cited by 66 · cited 1× · see citing works
“Additionally, no biomarkers for IBS have been validated.(8) Use of invalidated diagnostic or therapeutic approaches and good access to treatment may explain the high socioeconomic burden of IBS in Korea.”
BackgroundDifferent therapeutic regimens in irritable bowel syndrome.
Nigam, P., Kk, K., Ck, R., Kumar, A., & Gupta, A. (1984) · PubMed · Cited by 64 · see citing works
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Kuiken, S. D., Tytgat, G. N. J., & Boeckxstaens, G. E. (2003) · Clinical Gastroenterology and Hepatology · doi:10.1053/cgh.2003.50032 · Cited by 49 · see citing works
Altayar, O., Sharma, V., Prokop, L. J., Sood, A., & Murad, M. H. (2015) · Gastroenterology Research and Practice · doi:10.1155/2015/549308 · Cited by 47 · cited 1× · see citing works
“However, these studies had limitations, including a low methodological quality, relatively few patients, and no consideration of the heterogeneity of IBS, ie, IBS-D, IBS-C, and IBS-mixed.(132) In addition, conducting comparative or double-blinded trials of psychological therapies is difficult; therefore, we should pay…”
BackgroundRome III survey of irritable bowel syndrome among ethnic Malays
Lee, Y. Y. (2012) · World Journal of Gastroenterology · doi:10.3748/wjg.v18.i44.6475 · Cited by 39 · see citing works
Creating a multidisciplinary low back pain guideline: anatomy of a guideline adaptation process
Harstall, C., Taenzer, P. A., Angus, D. K., Moga, C., Schuller, T., & Scott, N. A. (2010) · Journal of Evaluation in Clinical Practice · doi:10.1111/j.1365-2753.2010.01420.x · Cited by 36 · see citing works
"Red flag" evaluation yield in irritable bowel syndrome.
Black, T. P., Manolakis, C. S., & Palma, J. A. D. (2012) · PubMed · Cited by 35 · see citing works
Nelson, T. A., Holmes, S., Alekseyenko, A. V., Shenoy, M. M., DeSantis, T. Z., Wu, C. H., Andersen, G. L., Winston, J. H., Sonnenburg, J. L., Pasricha, P. J., et al. (2010) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2010.01637.x · Cited by 33 · see citing works
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Fukudo, S., Kinoshita, Y., Okumura, T., Ida, M., Hayashi, K., Akiho, H., Nakashima, Y., & Haruma, K. (2016) · Journal of Gastroenterology · doi:10.1007/s00535-016-1165-5 · Cited by 27 · see citing works
Guidelines for the Treatment of Irritable Bowel Syndrome
Kwon, J. G., Park, K. S., Park, J. H., Park, J. M., Park, C. H., Lee, K. J., Park, H., Rhee, P., & The Korean Society of Neurogastroenterology and Motility (2011) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2011.57.2.82 · Cited by 26 · cited 17× · see citing works
“• Grade of recommendation: 1 • Level of evidence: B • Not voted in the revised edition Antispasmodics, including smooth muscle relaxants, antimuscarinic agents, anticholinergics, and calcium channel blockers, have long been used to treat IBS.”
BackgroundMethodInfluentialSohn, W., Lee, O. Y., Kwon, J. G., Park, K. S., Lim, Y. J., Kim, T. H., Jung, S., & Kim, J. I. (2012) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2012.01945.x · Cited by 26 · see citing works
Ke, M., Tack, J. F., Quigley, E. M. M., Zou, D., Choi, S. C., Leelakusolvong, S., Liu, A., & Kim, J. (2014) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm14029 · Cited by 25 · see citing works
Fukudo, S., Matsueda, K., Haruma, K., Ida, M., Hayase, H., Akiho, H., Nakashima, Y., & Hongo, M. (2017) · Neurogastroenterology & Motility · doi:10.1111/nmo.13023 · Cited by 25 · see citing works
Kim, E. S., Cheon, J. H., Park, J. J., Moon, C. M., Hong, S. P., Kim, T. I., & Kim, W. H. (2010) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2010.06338.x · Cited by 24 · cited 1× · see citing works
“The diagnostic yield of colonoscopy among IBS patients is very low.(29,30) However, certain “alarm signs” (unexplained weight loss, blood in the stool, anemia, and a recent change in bowel habits) call for special consideration of other disorders before symptoms can be attributed to IBS.”
BackgroundKim, T. I. (2009) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2009.54.6.413 · Cited by 19 · see citing works
Buono, J. L., Mathur, K., Averitt, A., & Andrae, D. A. (2016) · Journal of Medical Economics · doi:10.1080/13696998.2016.1269016 · Cited by 18 · cited 1× · see citing works
“Furthermore, inadequate symptom control results in a significant economic burden due to greater use of healthcare resources.(2) Population-based studies have reported that the prevalence of IBS is approximately 10% and is increasing in Asian countries.”
BackgroundAwad, R. A., Cordova, V. H., Dibildox, M., Santiago, R., & Camacho, S. (1997) · PubMed · Cited by 15 · see citing works
Diagnosis of Irritable Bowel Syndrome: a Systematic Review
Park, J. H., Byeon, J., Shin, W.-G., Yoon, Y. H., Cheon, J. H., Lee, K. J., Park, H., & The Korean Society of Neurogastroenterology and Motility (2010) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2010.55.5.308 · Cited by 15 · see citing works
Kim, H. J. (2015) · Korean Journal of Medicine · doi:10.3904/kjm.2015.89.2.179 · Cited by 5 · see citing works
Lee, O. Y., & Yoon, C. O. (2005) · Cited by 3 · see citing works
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Sex-gender differences in irritable bowel syndrome
Kim, Y. S., & Kim, N. (2018) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm18082 · Cited by 322 · see citing works
Clinical Practice Guidelines for Functional Dyspepsia in Korea
Oh, J. H., Kwon, J. G., Jung, H., Tae, C. H., Song, K. H., Kang, S. J., Kim, S. E., Jung, K., Kim, J. S., Park, J. K., et al. (2020) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm19209 · Cited by 81 · see citing works
How to Implement the 3-Phase FODMAP Diet Into Gastroenterological Practice
Sultan, N., Varney, J. E., Halmos, E. P., Biesiekierski, J. R., Yao, C. K., Muir, J. G., Gibson, P. R., & Tuck, C. J. (2022) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm22035 · Cited by 74 · see citing works
Bile Acid and Gut Microbiota in Irritable Bowel Syndrome
Min, Y. W., Rezaie, A. R., & Pimentel, M. (2022) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm22129 · Cited by 58 · see citing works
Efficacy of different probiotic protocols in irritable bowel syndrome
Ding, L., Ning, L., & Xu, G. (2019) · Medicine · doi:10.1097/md.0000000000016068 · Cited by 58 · see citing works
Guidelines on the management of irritable bowel syndrome
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Physical activity for treatment of irritable bowel syndrome
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Bacillus spp. Spores—A Promising Treatment Option for Patients with Irritable Bowel Syndrome
Cătinean, A., Neag, A. M., Nita, A., Buzea, M., & Buzoianu, A. D. (2019) · Nutrients · doi:10.3390/nu11091968 · Cited by 35 · see citing works
Effect of Heat-Killed Lactobacillus casei DKGF7 on a Rat Model of Irritable Bowel Syndrome
Seong, G., Lee, S., Min, Y. W., Jang, Y. S., Kim, H. S., Kim, E.-J., Park, S., Kim, C.-H., & Chang, D. K. (2021) · Nutrients · doi:10.3390/nu13020568 · Cited by 28 · see citing works
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2025 Seoul Consensus on Clinical Practice Guidelines for Irritable Bowel Syndrome
Choi, Y., Youn, Y. H., Kang, S. J., Shin, J. E., Cho, Y. S., Jung, Y. S., Shin, S. Y., Huh, C. W., Lee, Y. J., Koo, H. S., et al. (2025) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm25007 · Cited by 33 · see citing works
“10,16,17 The diagnosis of IBS begins with careful history-taking.”
Diet as a therapeutic tool in chronic gastrointestinal disorders: Lessons from the FODMAP journey
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World Gastroenterology Organisation Global Guidelines
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Clinical Practice Guidelines for the Treatment of Functional Dyspepsia in Korea
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AGA Institute Quality Indicator Development for Irritable Bowel Syndrome
Hung, K. W., Leiman, D. A., Kaza, A., Watson, R. R., Chang, L., & Maratt, J. K. (2025) · Gastroenterology · doi:10.1053/j.gastro.2024.11.003 · Cited by 12 · see citing works
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Survey-Based Analysis of the Clinical Treatment Status of Irritable Bowel Syndrome in Korea
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Pharmacologic Treatment of Irritable Bowel Syndrome with Predominant Constipation
Kim, D.-H., Song, H. Y., Nam, K., & the Korean Society of Neurogastroenterology and Motility (2025) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2025.002 · Cited by 6 · see citing works
A Survey on the Clinical Practice Patterns of Irritable Bowel Syndrome in Korean Medicine
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“이 이외의 내용은 영 문으로 출간된 ‘Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition’에 자세 히 소개되어 있으니 참고하기 바란다.(13)”
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Colorectal Diseases and Gut Microbiome
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Dietary Therapy in Irritable Bowel Syndrome
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Effect of antispasmodic agents for the treatment of irritable bowel syndrome
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Can Certain Foods Cause Gastrointestinal Symptoms in Korean Patients With Irritable Bowel Syndrome?
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تأثیر تدلیک القولون وتمرینات المرونة القسریة على الحد من بعض أعراض متلازمة القولون العصبی
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Angry Gut: Irritable Bowel Syndrome
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Future Direction of Research and Treatment Possibility for Irritable Bowel Syndrome
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Cha, B., Shin, J. E., Na, W., Kim, S. E., Lee, J. Y., You, H., & Kim, Y. S. (2025) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2025.112
Use of otilonium bromide in the treatment of abdominal pain
Pakhomova, I. G. (2026) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2026-185
Oral Health Impacts of Gastrointestinal Diseases: A Comprehensive Overview
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- Authors
- Song, K. H., Jung, H.-K., Kim, H. J., Koo, H. S., Kwon, Y. H., Shin, H. D., Lim, H. C., Shin, J. E., Kim, S. E., Cho, D. H., Kim, J. H., Kim, H. J., & The Clinical Practice Guidelines Group Under the Korean Society of Neurogastroenterology and Motility
- Affiliations
- Konyang University (KR)
- Ewha Womans University (KR)
- Gyeongsang National University (KR)
- Kyungpook National University (KR)
- Dankook University Hospital (KR)
- Yonsei University (KR)
- Kosin University (KR)
- Sungkyunkwan University (KR)
- Konkuk University (KR)
- Corresponding author
- Jung, Hye-Kyung
- ORCID
- Venue
- Journal of Neurogastroenterology and Motility
- Published
- 2018-04-30
- Volume
- 24
- Issue
- 2
- Pages
- 197-215
- ISSN
- 2093-0879 (ISSN-L)
- 2093-0887
- PMC
- PMC5885719
- OpenAlex
- W2800631112
- Cited by
- 47
- References
- 141
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 4 · 2023: 4 · 2022: 8 · 2021: 7 · 2020: 3 · 2019: 8 · 2018: 4
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of Neurogastroenterology and Motility (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- irritable bowel syndrome, IBS management, low FODMAP diet, probiotics, rifaximin, colonoscopy, IBS diagnosis, IBS pathophysiology
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