“We made a much stronger recommendation for testing for celiac disease in patients with diarrhea-predominant or mixed IBS,” Dr. Chey said. “We actually came out and said serologic screening for celiac disease should be pursued.”
Evidence of benefit from probiotics is also addressed. “Every one of my patients with IBS asked about probiotics,” Dr. Talley said.
“The guidelines will basically say that probiotics are efficacious, but the evidence supporting this is not as good as we would like,” he stated. The large number of probiotic products with varying degrees of efficacy precluded a stronger recommendation.
“Probiotics seem to be relatively safe as well, based on the data we have,” Dr. Talley said. “So I'm not uncomfortable with recommending a probiotic to my patients.”
He added, however, that some people are nonresponders.
In addition, recent evidence that indicates peppermint oil improves IBS symptoms will be in the update.
Dr. Schoenfeld disclosed that he is a consultant to, and is on the advisory committee for, Salix Pharmaceuticals Ltd., which markets Xifaxan.
Dr. Talley is also a consultant for Salix and a variety of other pharmaceutical companies, and receives financial support from several firms.
Dr. Chey reported no relevant financial disclosures for his presentation.
'What is uncertain is how long the symptom relief lasts and what you should do if the symptoms recur.' DR. SCHOENFELD