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 In women with symptoms suggestive of ovarian cancer, the recommendation to carry out a pelvic examination has been replaced by the recommendation to measure serum CA125 levels, in line with the NICE clinical guideline on ovarian cancer.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