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In December, the American College of Gastroenterology published its first Clinical Guideline on the Management of Irritable Bowel Syndrome (IBS), offering recommendations for testing and treatment. According to the guideline authors, 4.4% to 4.8% of the population experiences the disorder, characterized by altered bowel habits and abdominal pain. The guidelines recommend against routine colonoscopy, instead calling for the use of tricyclic antidepressants to treat global symptoms of IBS, gut-directed psychotherapies, and medications specific to IBS with constipation and IBS with diarrhea.
In addition to reading our e-newsletter, be sure to visit Today’s Geriatric Medicine’s website at www.TodaysGeriatricMedicine.com, where you’ll find news and information that’s relevant and reliable. We welcome your feedback at TGMeditor@gvpub.com. Follow Today’s Geriatric Medicine on Facebook and Twitter, too.
— Kate Jackson, editor |
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American College of Gastroenterology’s First Clinical Guideline on IBS
The American College of Gastroenterology (ACG) announces the publication of its first-ever ACG Clinical Guideline on the Management of Irritable Bowel Syndrome (IBS), which was recently published in The American Journal of Gastroenterology. The guideline provides clinical recommendations for both diagnostic testing and therapeutic treatments for IBS.
IBS is a disorder of bowel function and sensation in which patients have changes in bowel habits such as constipation or diarrhea and abdominal pain, along with other symptoms including abdominal bloating, and rectal urgency with diarrhea. The guideline authors write that IBS is estimated to affect 4.4% to 4.8% of the population, according to Rome IV diagnostic criteria, and more commonly affects women than men.
“We are very proud to release the first ever ACG Clinical Guideline on IBS. We identified 25 clinically important questions that clinicians frequently ask and then used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology to carefully and critically evaluate the data. We believe that these new IBS guidelines can be effectively used in daily practice to help expedite care and to improve symptoms in patients with IBS,” says guideline coauthor Brian E. Lacy, MD, PhD, FACG, coeditor in chief of the American Journal of Gastroenterology.
The guideline, jointly authored by Lacy; Mark Pimentel, MD, FRCPC; Darren M. Brenner, MD, FACG; William D. Chey, MD, FACG; Laurie Keefer, PhD; Millie D. Long, MD, MPH, FACG; and Baha Moshiree, MD, FACG, provides 25 recommendations, including the following:
• diagnostic testing to rule out celiac disease and inflammatory bowel disease (IBD) in patients with suspected IBS and diarrhea, which is not routinely performed by many health care providers;
• recommending against routine colonoscopy in patients with IBS symptoms under age 45 who do not exhibit warning signs such as unintentional weight loss, older age of onset of symptoms, or family history of IBD, colon cancer, or other significant gastrointestinal disease;
• treatment of IBS with constipation (IBS-C) symptoms with guanylate cyclase activators and treatment of IBS with diarrhea (IBS-D) symptoms with a gut-selective antibiotic;
• the use of tricyclic antidepressants to treat global symptoms of IBS, including its key symptom, abdominal pain; and
• gut-directed psychotherapies to treat overall IBS symptoms as part of a comprehensive management strategy, rather than as a last resort, that can be used in conjunction with dietary therapies and medications.
Full story » |
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Anemia: A Risk Factor for COVID-19
Low Hgb levels disrupt the transportation of oxygen, which can lead to multiple organ dysfunction and severe disease. Read more »
Probiotics and Immune Health
Research on the role of the gut microbiota is evolving rapidly. Read more »
Access to Care
The pandemic is creating a greater gap in sexual health services for older adults. Read more » |
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A Second Look at Prediabetes
A new study questions whether prediabetes is a significant concern for older adults. According to the study’s senior author, Elizabeth Selvin, PhD, a Johns Hopkins Bloomberg School of Public Health epidemiologist, “In most older adults, prediabetes probably shouldn’t be a priority.” A New York Times article questions whether saddling individuals with a diagnosis of prediabetes isn’t “‘medicalizing’ a normal part of aging, creating needless anxiety for those already coping with multiple health problems?”
Boredom a Health Hazard
Researchers worry that boredom, one symptom of “pandemic fatigue,” may cause individuals to throw caution to the wind and engage in activities without social distancing and proper precautions. Sujata Gupta reports on the issue in Science News.
Genetic Clues to Lewy Body Dementia
National Institutes of Health researchers have discovered that five genes play a critical role in determining whether one develops Lewy body dementia. Published in Nature Genetics, Science Daily reports, the study also indicates that Lewy body is caused by problems seen in Alzheimer’s and Parkinson’s disease.
An Early Window on Alzheimer’s Disease
“Forget the soul—it turns out the eyes may be the best window to the brain,” writes Elizabeth Anne Brown in the Washington Post. She’s referring to the work of a team of researchers on early Alzheimer’s intervention and treatment at Cedars-Sinai who have developed an inexpensive technique to see Alzheimer’s plaques in the retinal neurons of individuals living with mild cognitive impairment. |
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Eradicating COVID-19
Third-party testing indicates that R-Water’s health care grade disinfectant TK60, used in health care facilities, educational institutions, sports complexes, and restaurants, kills 99.99% of coronavirus in 20 seconds. It’s hypoallergenic, and its active ingredient is hypochlorous acid, the compound white blood cells naturally produce to fight infection. Learn more »
Companionship for Older Adults
Papa, a comprehensive health management platform from Papa Health available through a variety of health plan providers, offers older adults and their families companionship and help with everyday tasks. “Papa Pals” help patients navigate medical appointments and provide transportation and care facilitation. They also can ensure that participants eat healthfully, exercise, and take their medications.
Learn more » |
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