Shazia Siddique MD MS
Shazia Siddique MD MS

@ShaziaMSiddique

7 Tweets 4 reads Jun 24, 2022
#Tweetorial on the new updated @AmerGastroAssn Guidelines in @AGA_Gastro on #IBS below πŸ‘‡πŸΎ
All ⭐️ Guideline Panel: @LinChangMD @AnthonyLemboMD @SultanShazi @jheidel Walter Smalley & Nicholas Verne
More info: ow.ly
Core components for all patients with IBS:
πŸ”Έ strong pt-provider relationship
πŸ”Έ education & reassurance
πŸ”Έdietary modifications (e.g. low FODMAP diet)
πŸ”Έ lifestyle modifications (exercise, sleep, ⬇️ stress)
Pharm mgmt of pts with IBS (regardless of type):
βœ… antispasmodics for abdominal pain
βœ… TCAs (8 RCTs with clinically meaningful ⬆️ in global sx)
❌ SSRIs (7 RCTs: no sig ⬆️ global sx or abd pain)
*Note that these are conditional recommendations with low certainty in evidence*
.@AmerGastroAssn Guideline on IBS-Diarrhea:
βœ… eluxadoline (do not use in pts with no GB or EtOH >3x/d)
βœ… rifaximin, incl re-tx in those with recurrent sx after initial response
βœ… alosetron
*conditional recs w/moderate certainty in evidence*
βœ… loperamide (w/very low certainty)
.@AmerGastroAssn Guideline on IBS-Constipation:
βœ… Linaclotide (linzess)- Strong Rec/High Qual Evid
And conditional recs & moderate evid for:
βœ… Tenapanor (ibsrela)
βœ… Plecanatide (trulance)
βœ… Lubiprostone (amitiza)
βœ… Tegaserod ➑️ re-approved for women <65yo w/o hx CV events
For pts with persistent #IBS sx despite above therapy, the @AmerGastroAssn Clinical Decision Support Tool calls for considering:
πŸ”Έadding or switching to a low dose TCA
πŸ”ΈSNRI
πŸ”ΈBrain-Gut Behavior Therapy incl CBT and hypnosis
Don't miss the opportunity to hear directly from the @AGA_Gastro authors! @LinChangMD @AnthonyLemboMD @SultanShazi @jheidel Walter Smalley & Nicholas Verne
Join our Gastro Bites webinars on
πŸ”ΉJuly 7 at noon EDT
πŸ”ΉJuly 21 at noon EDT
Register here: ow.ly

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