John Damianos, M.D. Profile picture
@MayoClinicGIHep Gastroenterology & Hepatology Fellow. Yale Internal Medicine, Dartmouth Med. 🦠Microbiome, brain-gut axis, diet, IBS, IBD, motility, #MedEd🇬🇷

Oct 24, 2021, 25 tweets

Evidence-based approach to #IBS (C and D) from @LinChangMD at @AmCollegeGastro #ACG2021

#GITwitter

FGIDs ▶️ DGBIs 🧠

#IBS diagnosis

🚨 Alarm features

Limited diagnostic testing in #IBS to rule out certain other disorders

After limited screening for other disorders, make a POSITIVE diagnosis of #IBS (NOT a diagnosis of exclusion) using the @RomeFoundation IV criteria

Characterize #IBS by subtype using the Bristol 💩 scale

Use the 2⃣5⃣% mark

Diagnosing #IBS

Overview of #IBS-D treatment options

Treatment algorithm for #IBS-D

Consider peppermint oil, antispasmodics, and TCAs

Rifaximin is useful and can be repeated up to twice

Eluxadoline for IBS-D

💎s on #IBS-D treatment

Treatment options for #IBS-C

Algorithm for the treatment of #IBS-C

Approved therapies for #IBS-C and #CIC

Linaclotide effective for #constipation, pain, and bloating

Tegaserod is another good option

💎s on #IBS-C treatment

Modify treatment based on response

Pharmacology of neuromodulators

💎s on neuromodulators in #IBS

Psychological-based therapies in #IBS

Behavioral therapy in #IBS

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