1.Background and purpose
Irritable bowel syndrome (IBS; K58) is a functional gastrointestinal disorder that has characterized symptoms, such as diarrhea and constipation without specific organic causes. Although IBS is a common condition with a worldwide prevalence rate of around 5-10%, due to its complex pathophysiology and limitations of conventional treatments, there has been increasing interest in its treatment using Korean medicine or complementary and alternative medicine. However, since no Korean medicine treatment guidelines for IBS have been established to date, it has been difficult to perform appropriate application and evaluation for various Korean medicine treatments in clinical practice. Therefore, the development of Korean medicine clinical practice guideline for IBS may suggest right instructions for the diagnosis and treatments of Korean medicine doctors (KMDs) and provide useful information for the improvement of symptoms and quality of life, which could reduce social costs and loss of medical resources. This guideline was developed through analysis and synthesis of data based on evidence-based methodology and reviewed by an expert group to provide appropriate information for KMDs and patient.
2. Overview of disease
Irritable bowel syndrome (IBS) is a representative functional gastrointestinal disorder with chronic recurrence of characteristic symptoms, such as abdominal pain, cramping or bloating, relief of symptoms after a bowel movement, changes in the frequency of the bowl movement or changes in the stool type. The international diagnostic criteria for IBS is the Rome criteria, which has been revised several times after the Rome I criteria was first released in 1992, and the current Rome IV criteria was published in 2016. The scope of this guideline includes only the type of IBS which meets the Rome diagnostic criteria.
Regarding the pathogenesis of IBS, altered gastrointestinal motility, visceral hypersensitivity, abnormality in the brain-gut interactions, intestinal infection and inflammation, and psychosocial factors have been suggested. However, the pathogenesis has complex associations with various causes; therefore, it has been reported that evidence-based treatment methods have imitations in the improvement of the condition. Therefore, although there are treatments based on western medicine that include the administration of antispasmodic, anti-diarrheal, and constipation drugs, since most of these treatments are aimed at alleviating symptoms, interest in Korean medicine treatments, such as herbal medicine, acupuncture, and moxibustion, has continued to increase.
