An Individualized, Case-Based Approach to the Management of Irritable Bowel Syndrome

LEARNING OBJECTIVES
• Describe the multiple symptoms of irritable bowel syndrome (IBS) and their
impact on quality of life
• Use a staged strategy for the diagnostic
evaluation of IBS based on history and
physical examination, including Rome
IV criteria
• Individualize treatment for IBS based
on an evolving understanding of
pathophysiologic mechanisms using
evidence-based therapies to address
patient concerns and improve quality
of life
TARGET AUDIENCE
Family physicians and clinicians who wish to gain increased knowledge and greater competency regarding primary care management of irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder that affects 10% to 15% of the US population. IBS is more prevalent in women and in persons younger than 50 years. IBS is characterized by recurrent abdominal pain and altered bowel habits; bloating and distention frequently coexist. Based on the predominant bowel habit pattern, IBS is classified as constipation-predominant (IBS-C), diarrheapredominant (IBS-D), or a mixed pattern of constipation and
diarrhea (IBS-M). Patients with IBS-D have significantly lower self-esteem than healthy controls and patients with IBS-C. Regardless
of which type of IBS a patient may have, IBS sufferers report
significantly greater symptom severity than patients with inflammatory bowel disease (IBD). Approximately one-third of people with IBS-D experience mild symptoms, one-half have moderate symptoms, and 1 in 8 have severe symptoms. The IBS in America survey showed that three-quarters of persons with IBS symptoms tried an average of 3 nonprescription products before seeking medical care. Abdominal pain was the most common reason people sought medical care.

LEARNING OBJECTIVES
• Describe the multiple symptoms of irritable bowel syndrome (IBS) and their impact on quality of life
• Use a staged strategy for the diagnostic evaluation of IBS based on history and physical examination, including Rome IV criteria
• Individualize treatment for IBS based on an evolving understanding of
pathophysiologic mechanisms using evidence-based therapies to address patient concerns and improve quality of life
TARGET AUDIENCE
Family physicians and clinicians who wish to gain increased knowledge and greater competency regarding primary care management of irritable bowel syndrome.

ACCREDITATION
The Primary Care Education Consortium is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
CREDIT DESIGNATION
AMA PRA Category 1 – Primary Care Education Consortium designates this enduring material for a maximum of 1.0 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. CME is available September 1, 2020 to August 31, 2021.

METHOD OF PARTICIPATION PHYSICIANS: To receive CME credit,
please read the journal article and, on completion, go to www.pceconsortium. org/ibs to complete the online post-test and receive your certificate of completion.
PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS: AANP, ANCC, and AAPA accept certificates of participation of educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME.

SUPPORTER
This article is supported by an educational grant from Allergan and Ironwood Pharmaceuticals.
FACULTY
Brian E. Lacy, MD, PhD, FACG, Co-Editor in Chief, American Journal of Gastroenterology, Professor of Medicine, Senior
Associate Consultant, Mayo Clinic, Jacksonville, FL
ACKNOWLEDGMENT
Editorial support was provided by Gregory Scott, PharmD, RPh, at the Primary Care Education Consortium (PCEC).

AMA PRA Category 1 – Primary Care Education Consortium designates this enduring material for a maximum of 1.0 AMA
PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. CME is available September 1, 2020 to August 31, 2021.