Irritable bowel syndrome and IBS-like syndrome: current concepts, diagnosis, treatment approaches

The article presents the latest international guidelines on functional gastrointestinal disorders (Rome IV criteria). It is difficult to consider all functional disorders within one paper, and therefore it was decided to address the problem using the example of the most common functional disorder – irritable bowel syndrome (IBS) and a similar IBS-like syndrome (IBS-LS), which is particularly problematic in clinical practice. The case is illustrated by our own findings i.e. an analysis of 130 patients (80 with IBS and 50 with IBS-LS). The treatment included a specialized probiotic ProbioLog IBS (1 capsule per day) and involved several steps (each step comprises 2 weeks, 6 weeks in total). At the end of each treatment step, the therapy was evaluated followed by correction of the following step. The effectiveness of treatment was 80%; additional correction was required for 10% of patients with persistent pain, which was relieved by adding Meteospasmil to the treatment combination. Administration of digestive enzymes was required for 10% of patients with IBS-PS, which developed due to chronic pancreatitis at the stage of exocrine pancreatic insufficiency. Thus, the therapeutic effect on altered microbiota, one component of the pathological symptom group (IBS and IBS-LS), with a probiotic containing three bacterial strains targeted in IBS (ProbioLog IBS) was effective in 80% of patients, and only 20% needed additional correction of treatment with motility regulators and enzyme drugs.