[en] Background: Irritable bowel syndrome (IBS) is characterised by recurrent abdominal pain related to defaecation or associated with altered stool frequency or consistency. Despite its prevalence, major uncertainties in the diagnostic and therapeutic management persist in clinical practice. Methods: A Delphi consensus was conducted by 20 experts from Belgium, and consisted of literature review and voting process on 78 statements. Grading of recommendations, assessment, development and evaluation criteria were applied to evaluate the quality of evidence. Consensus was defined as > 80 % agreement. Results: Consensus was reached for 50 statements. The Belgian consensus agreed as to the multifactorial aetiology of IBS. According to the consensus abdominal discomfort also represents a cardinal symptom, while bloating and abdominal distension often coexist. IBS needs subtyping based on stool pattern. The importance of a positive diagnosis, relying on history and clinical examination is underlined, while additional testing should remain limited, except when alarm features are present. Explanation of IBS represents a crucial part of patient management. Lifestyle modification, spasmolytics and water-solube fibres are considered first-line agents. The low FODMAP diet, selected probiotics, cognitive behavioural therapy and specific treatments targeting diarrhoea and constipation are considered appropriate. There is a consensus to restrict faecal microbiota transplantation and glutenfree diet, while other treatments are strongly discouraged. Conclusions: A panel of Belgian gastroenterologists summarised the current evidence on the aetiology, symptoms, diagnosis and treatment of IBS with attention for the specificities of the Belgian healthcare system (Acta gastroenterol. belg., 2022, 85, 360-382).
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Kindt, Sébastien; Department of gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussel, Belgium
Louis, H; Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
De Schepper, H; Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium
Arts, J; Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium, ( ; Department of Gastroenterology, AZ Sint-Lucas, Brugge, Belgium
Caenepeel, P; Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium, ( ; Department of Gastroenterology, Ziekenhuis Oost-Limburg, Genk, Belgium, ( ; UHasselt, Hasselt, Belgium
De Looze, D; Department of Gastroenterology and Hepatology, University Hospital Ghent, Gent, Belgium
Gerkens, A; Boitsfort Medical Center, Brussels, Belgium
Holvoet, T; Department of Gastroenterology and Hepatology, University Hospital Ghent, Gent, Belgium, ( ; Department of Gastroenterology, AZ Nikolaas, Sint Niklaas, Belgium
Latour, Pascale ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive
Mahler, T; Department of Pediatrics, Universitair Ziekenuis Brussel, Brussel, Belgium
Mokaddem, F; Department of Gastroenterology and Hepatology, Vivalia-Centre Sud Luxembourg, Arlon, Belgium
Nullens, S; Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium
Piessevaux, H; Department of Hepato-gastroenterology, Cliniques universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium
Poortmans, P; Department of gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussel, Belgium
Rasschaert, G; Department of gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussel, Belgium
Surmont, M; Department of gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussel, Belgium
Vafa, H; Department of Gastroenterology and Hepatology, Chirec-Site Delta, Brussels, Belgium
Van Malderen, K
Vanuytsel, T; Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium, ( ; Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
Wuestenberghs, F; Department of Gastroenterology and Hepatology, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Tack, J; Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
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