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Review
. 2019 Jul 1;25(3):343-362.
doi: 10.5056/jnm19041.

Second Asian Consensus on Irritable Bowel Syndrome

Kok Ann Gwee  1 , Sutep Gonlachanvit  2 , Uday C Ghoshal  3 , Andrew S B Chua  4 , Hiroto Miwa  5 , Justin Wu  6 , Young-Tae Bak  7 , Oh Young Lee  8 , Ching-Liang Lu  9 , Hyojin Park  10 , Minhu Chen  11 , Ari F Syam  12 , Philip Abraham  13 , Jose Sollano  14 , Chi-Sen Chang  15 , Hidekazu Suzuki  16 , Xiucai Fang  17 , Shin Fukudo  18 , Myung-Gyu Choi  19 , Xiaohua Hou  20 , Michio Hongo  21
Affiliations
Review

Second Asian Consensus on Irritable Bowel Syndrome

Kok Ann Gwee et al. J Neurogastroenterol Motil. .

Abstract

Background/aims: There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus.

Methods: Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method.

Results: Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy.

Conclusions: Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.

Keywords: Asia; Constipation; Diarrhea; Intestines; Irritable bowel syndrome.

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Conflict of interest statement

Financial support and conflicts of interest: Kok Ann Gwee reports grants and personal fees from Abbott Laboratories (speaking honorarium and education grant), Þisai (education grant), Janssen Pharmaceuticals (education grant), Menarini Asia-Pacific (advisory board, speakers’ bureau and consultancy), Biocodex (advisory board), Pfizer (advisory board), LF Asia (education grant), and Teva Pharmaceutical (speaking honorarium) during the conduct of the study; Sutep Gonlachanvit reports personal fees and non-financial support from Takeda, Thailand, personal fees from Abott, Thailand, personal fees, and non-financial support from Eisai, Thailand, outside the submitted work; Uday C Ghoshal has an Indian patent (application No. 201611031351; Indigenous radio-opaque markers for assessment of colonic transit time) pending and another Indian patent (application No. 201711040370; A double lumen tube assembly to prevent contamination by inhabitant microbes from proximal parts such as oropharynx) pending. Hiroto Miwa reports grants and personal fees (speaking honorarium) from Astellas and Mylan EPD during the conduct of the study; Justin Wu reports personal fees from Menarini outside the submitted work; Hidekazu Suzuki reports personal fees from Takeda, personal fees from Otsuka, personal fees from Astellas, personal fees from EA Pharma, personal fees from Daiichi-Sankyo, personal fees from Mylan EPD, personal fees from Astrazeneca, grants from Daiichi-Sankyo, outside the submitted work; Shin Fukudo reports the following activities outside the submitted work; personal fees from Dainippon Sumitomo Pharma, grants and personal fees from Abott Japan, personal fees from Scampo Pharma, grants from Ono Pharmaceutical, grants and personal fees from Astellas Pharmaceutical, personal fees from Sanwa Chemical Co. Ltd, personal fees from Zeria, personal fees from Glaxo-Smith-Kline, personal fees from Mochida Pharmaceutical, personal fees from Shionogi Pharmaceutical, grants and personal fees from AstraZeneca, grants from Smoking Research Foundation, grants and personal fees from Tsumuta Co. Ltd, personal fees and non-financial support from Miyarisan Pharmaceutical, grants from Kao Co. Ltd, and grants from Zespri Co. Ltd, and grants and personal fees from Kissei Pharmaceutical. Michio Hongo reports personal fees from Astellas, personal fees from Mylan EPD, personal fees from Kissei, during the conduct of the study, and personal fees from Sanwa Kagaku, personal fees from Mochida, outside the submitted work.

References

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