New ACG IBS Guidelines with Brian E. Lacy, MD, PhD

In this episode, Brian E. Lacy, MD, PhD, joins us to discuss the American College of Gastroenterology's newest guidelines for irritable bowel syndrome, options for patients with IBS-D and IBS-C, and much more. Brought to you by Red Hill Biopharma. Intro :02 Can you briefly review the process that led to the final document? 1:31 All recommendations are not created equal in this guideline or any guideline … do you think that is a fair statement? 3:56 Do you have some key takeaways for listeners in regards to the diagnostic evaluation of patients with IBS? 4:38 There's always this debate about fecal calprotectin or fecal lactoferrin or CRP … what do you do in your own practice? 6:13 What do you want to tell the listeners in terms of testing to adequately screen for Celiac disease in their patients with IBS symptoms? 7:49 Does it matter how you biopsy? 9:57 What was your perspective on some of the new serologies for IBS? 11:51 Can you review pelvic floor testing in patients with IBS and what the listeners should be thinking about and what they should do? 15:00 Do you see potentially IBS-D and IBS-C-specific guidelines coming out in the future? 17:14 Several commonly used therapies for IBS have weak recommendations or recommendations against their use. Can you talk about this or whether you use these therapies in your practice? 20:29 What do you tell patients when they ask you about whether they should get their stool analyzed or provide you with a report from testing they've already done? 26:10 Stool samples: are they even the best thing we should be measuring? 29:07 What's the proportion of patients that possibly or potentially mismanaged getting colonoscopies, being started on expensive medications, being started on probiotics and how do we shift from this guideline and really getting this spread out in practice? 30:44 The growing list of options for patients with IBS and constipation 37:57 Opinions on the available options for patients with IBS-D? 39:49 Thank you again, Dr. Lacy 41:15 Brian E. Lacy, MD, PhD, is a board certified gastroenterologist at the Mayo Clinic and the current co-editor in chief of the American Journal of Gastroenterology. He is the former editor in chief of Clinical and Translational Gastroenterology and was the co-chairman for the Rome IV Committee on Functional Bowel Disorders. Disclosures: Berry, Chey and Lacy report no relevant financial disclosures. We'd love to hear from you! Send your comments/questions to Dr. Berry and Dr. Chey at [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc