190 research outputs found
Burden of persistent symptoms in treated coeliac disease: cause, aftermath or merely association?
No full textEditorial: recognising the efficacy of licensed drug therapies for IBS on bloating—a step in the right direction for targeted treatment?
No full textTRANSLATIONAL STUDIES IN THE DEVELOPMENT OF NEUROSTIMULATION BASED INTERVENTIONS FOR REHABILITATION OF DYSPHAGIA AFTER STROKE
Full text linkEditorial: important insights into prescribing practices and training needs of gastroenterologists regarding use of central neuromodulators in IBS
No full textBritish Society of Gastroenterology guidelines on the management of irritable bowel syndrome
Full text linkIrritable 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 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 upon 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
Global prevalence of irritable bowel syndrome: time to consider factors beyond diagnostic criteria?
No full textGlobal prevalence of irritable bowel syndrome: time to consider factors beyond diagnostic criteria?
No full textGlobal prevalence of irritable bowel syndrome: time to consider factors beyond diagnostic criteria?
No full textEffect of brain-gut behavioral treatments on abdominal pain in irritable bowel syndrome: systematic review and network meta-analysis
Full text linkBackground and aims: some brain-gut behavioral treatments (BGBTs) are beneficial for global symptoms in irritable bowel syndrome (IBS). US management guidelines suggest their use in patients with persistent abdominal pain but their specific effect on this symptom has not been assessed systematically.Methods: we searched the literature through 16th December 2023 for randomized controlled trials (RCTs) assessing efficacy of BGBTs for adults with IBS, compared with each other, or a control intervention. Trials provided an assessment of abdominal pain resolution or improvement at treatment completion. We extracted data as intention-to-treat analyses, assuming dropouts to be treatment failures and reporting pooled relative risks (RRs) of abdominal pain not improving with 95% confidence intervals (CIs), ranking therapies according to P-score.Results: we identified 42 eligible RCTs, containing 5220 participants. After treatment completion, the BGBTs with the largest numbers of trials, and patients recruited, demonstrating efficacy for abdominal pain, specifically, included self-guided/minimal contact cognitive behavioral therapy (CBT) (RR = 0.71; 95% CI 0.54-0.95, P-score 0.58), face-to-face multicomponent behavioral therapy (RR = 0.72; 95% CI 0.54-0.97, P score 0.56), and face-to-face gut-directed hypnotherapy (RR = 0.77; 95% CI 0.61-0.96, P-score 0.49). Among trials recruiting only patients with refractory global IBS symptoms, group CBT was more efficacious than routine care for abdominal pain, but no other significant differences were detected. No trials were low risk of bias across all domains and there was evidence of funnel plot asymmetry.Conclusions: several BGBTs, including self-guided/minimal contact CBT, face-to-face multicomponent behavioral therapy, and face-to-face gut-directed hypnotherapy may be efficacious for abdominal pain in IBS, although none were superior to another
Towards better management of functional sphincter of oddi disorder: the need to look beyond the endoscope
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