J Neurogastroenterol Motil.  2019 Jul;25(3):343-362. 10.5056/jnm19041.

Second Asian Consensus on Irritable Bowel Syndrome

  • 1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, and Gleneagles Hospital, Singapore.
  • 2Center of Excellence on Neurogastroenterology and Motility, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. gsutep@hotmail.com
  • 3Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
  • 4Gastro Centre, Ipoh, Malaysia.
  • 5Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho, Nishinomiya, Hyogo, Japan.
  • 6Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong.
  • 7Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
  • 8Department of Gastroenterology, College of Medicine, Hanyang University, Seoul, Korea.
  • 9Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.
  • 10Division of Gastroenterology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 11Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
  • 12Division of Gastroenterology, Departement of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
  • 13Division of Gastroenterology, P D Hinduja Hospital, Mumbai, India.
  • 14Department of Internal Medicine, Division of Gastroenterology, University of Santo Tomas, Manila, Philippine.
  • 15Taichung Veterans General Hospital, Taiwan Boulevard, Taichung City, Taiwan.
  • 16Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
  • 17Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
  • 18Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Aoba Sendai, Japan.
  • 19Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
  • 20Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • 21Department of Medicine, Kurokawa General Hospital, Kurokawa, Miyagi, Japan.


There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus.
Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method.
Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy.
Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.


Asia; Constipation; Diarrhea; Intestines; Irritable bowel syndrome
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