Survey of Latin American gastroenterologists, specialists in disorders of gut-brain interaction, on the diagnosis and treatment of irritable bowel syndrome in clinical practice

Rev Gastroenterol Mex (Engl Ed). 2025 Oct 18:S2255-534X(25)00121-5. doi: 10.1016/j.rgmxen.2025.10.001. Online ahead of print.

ABSTRACT

INTRODUCTION AND AIM: Even though the guidelines on irritable bowel syndrome (IBS) are similar worldwide, there are differences between countries that can influence management. Our aim was to evaluate the heterogeneity in IBS management in Latin America.

MATERIALS AND METHODS: An internet survey was applied to 97 gastroenterologists, specialists in disorders of gut-brain interaction (DGBI), from 14 Latin American countries, and included 111 questions: 23 on diagnosis and 88 on treatment. An exploratory, descriptive, observational analysis was carried out on general qualitative data, by IBS subtype and by country.

RESULTS: Diagnostic data: 98% of those surveyed utilize the Rome IV criteria; 100% order laboratory tests when there are alarm symptoms; 90% order colonoscopy in patients over 50 years of age; 73% order abdominopelvic CT; 66% order breath tests for SIBO; and 96% order anorectal manometry in IBS-C with symptoms of a defecation disorder. Treatment data: antispasmodics are the most widely prescribed drugs, with differences according to IBS subtype and local availability; 83% indicate a low FODMAP diet; in IBS-D and abdominal distension, more than 90% prescribe rifaximin and/or probiotics, and 81%, cholestyramine; in IBS-C, the most widely prescribed treatments are polyethylene glycol, psyllium, prucalopride, and linaclotide; up to 94% indicate neuromodulators as second-line treatment; and 99% consider indicating psychotherapy in cases of depression.

CONCLUSIONS: Even though most of the specialists diagnose and treat IBS in accordance with guidelines, there are differences regarding local availability, and abdominopelvic CT appears to be overused. Knowing how general practitioners and internists manage this entity would be useful for establishing practical guidelines on the diagnosis and treatment of IBS that are adjusted by country.

PMID:41111058 | DOI:10.1016/j.rgmxen.2025.10.001