Linaclotide recommended in updated NICE IBS guideline

NICE guidance on the care of adults with irritable bowel syndrome (IBS) has been updated to include linaclotide as a treatment option.

IBS mostly affects people aged 20-30 years and is twice as commen in women as in men. | SCIENCE PHOTO LIBRARY
IBS mostly affects people aged 20-30 years and is twice as commen in women as in men. | SCIENCE PHOTO LIBRARY

The guideline covers the support, treatment and advice patients with IBS should be offered by GPs, and the circumstances in which patients should be referred to a specialist for futher investigation.

The major change in the 2015 edition of the guideline is the recommendation of the guanylate cyclase C agonist linaclotide (Constella) as a treatment option for patients with IBS if:

  • optimal or maximum tolerated doses of previous laxatives from different classes have not helped, and
  • they have had constipation for at least 12 months.

GPs should review patients taking linaclotide after 3 months.

The 'initial assessment' section of the guidance has also been updated. In women with symptoms suggestive of ovarian cancer, the recommendation to carry out a pelvic examination has been replaced by the recommendation to measure serum CA125 levels, in line with the NICE clinical guideline on ovarian cancer.

These changes are reflected in the quick-reference MIMS guideline summary, which can be found online and in the forthcoming June print edition of MIMS.

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