(THIRD ISSUE/VOLUME) “IBS” HEALTH CARE ECONOMICS AND OUTCOMES RESEARCH (HEOR): How can clinical outcomes be improved combined with reduced health care utilization and costs? 4. (SECOND ISSUE/VOLUME) “IBS” MANAGEMENT AND EDUCATION: What treatment and management strategies are effective and actionable, including the best of gastroenterology with that of functional, integrative, and complementary/alternative medicine? 3. (FIRST ISSUE/VOLUME) “IBS” DEFINITIONS, PATHOPHYSIOLOGY, AND DIFFERENTIAL DIAGNOSIS: Can accurate recognition and diagnosis be simplified, efficient, and largely non-invasive? 2. (IBS is enclosed in quotation marks (“IBS”) to emphasize and remind of the importance of accurate differential diagnosis of the “IBS” enteropathy symptom triad, which includes both IBS (a DGBI) and/or one or more of the six enteropathies listed above.) 1. THE GOAL OF THIS RESEARCH TOPIC ON “IBS” PRESENTED IN FOUR ISSUES OF FRONTIERS IN GASTROENTEROLOGY IS TO DEVELOP A FORUM FOR “REAL-WORLD” ANSWERS TO FOUR QUESTIONS RESPECTIVELY. The average time to diagnosis is 4 years. However, the reality is much unnecessary testing is conducted, including colonoscopy, and both patients and health care professionals are dissatisfied and frustrated with management and clinical outcomes. In the absence of concerning clinical features, experts advocate making a positive diagnosis of IBS with limited non-invasive evaluation. Food and ingested (including FODMAPs - poorly digested carbohydrates), sucrose, fiber, wheat/gluten, and dietary additives,.Gut microbiome dysbiosis (present in the majority),.Notably, there are 6 other common and specifically treatable enteropathies that either mimic IBS or are co-morbidities. The “real world” reality is that IBS (the DGBI) is an enteropathy symptom triad: Many are referred to gastroenterologists who are in short supply and commonly depend upon advanced practice providers since these patients comprise up to 40% of visits. In American primary care, 12% of visits are for IBS, which is the 7th most common diagnosis. For the minority who consult for IBS, quality of life is impaired and high healthcare utilization and costs result.
Most have associated non-gastrointestinal chronic illness and potentially life-threatening disease. IBS has a high worldwide prevalence of around 10% and is the most common disorder of gut-brain interaction (DGBI), which collectively has a worldwide prevalence of 40%.
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