Evidence

Surveillance report 2017 – Irritable bowel syndrome (2008) NICE guideline CG61

Surveillance decision

Surveillance decision

We will not update the guideline on irritable bowel syndrome (IBS) at this time.

During surveillance editorial or factual corrections were identified. Details are included in appendix A: summary of evidence from surveillance.

Reason for the decision

Assessing the evidence

We found 156 studies through surveillance of this guideline.

This included evidence suggesting possible effects of ondansetron and dietary supplements such as vitamin D and a herbal medicine combination of fennel oil plus curcumin. We asked topic experts whether this evidence would affect current recommendations. Generally, the topic experts thought that an update of these areas was not needed.

We also identified evidence that supports current recommendations on:

  • diagnosis of irritable bowel syndrome, including evidence that supports NICE diagnostic guidance on SeHCAT (tauroselcholic [75 selenium] acid) testing for bile acid malabsorption and on faecal calprotectin testing

  • low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet, other exclusion diets, dietary supplements and probiotics

  • physical activity interventions

  • drug treatments including antispasmodics, laxatives, antidepressants

  • psychological therapies such as cognitive behavioural therapy (CBT)

  • alternative therapies, for example, hypnotherapy, biofeedback, relaxation, acupuncture and herbal medicine.

We found evidence on serotonin 5‑HT3 and 5‑HT4 receptor antagonists, which was not covered in the guideline. However, the evidence was insufficient to add new recommendations in this area at this time.

For any new evidence relating to published or ongoing NICE technology appraisals, the guideline surveillance review deferred to the technology appraisal decision. This included a study of eluxadoline, which is currently being evaluated, and technology appraisal guidance is expected in 2017.

Equalities

No equalities issues were identified during the surveillance process.

Overall decision

After considering all the evidence and views of topic experts and stakeholders, we decided that no update is necessary for this guideline.

See how we made the decision for further information.


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