Algorithm for managing patients with irritable bowel syndrome. Roman criteria IV
Maev Maev I.V.¹, Cheryomushkin S.V.¹,², Kucheryavy Yu.A.¹, Cheryomushkina N.V.<sup>1

1</sup> Moscow State Medical Stomatological University named after А.I. Evdokimov
² Central Clinical Hospital of Russian Railways named after N.A. Semashko

Irritable Bowel Syndrome (IBS) is a recurrent functional disorder of the gastrointestinal tract, the diagnosis of which remains exclusively clinical. The article thoroughly examines the Roman criteria IV, which were published in 2016 and included a number of fundamentally important differences from the previous version. In the etiopathogenesis of IBS the main role is played by socioeconomic status, genetic predisposition, psychological aspects, visceral hypersensitivity, gastrointestinal motility disorders (GMD), changes in the neuroendocrine system, low-grade inflammation, the concept of post-infection IBS, the imbalance of the microbiota, and, finally, various nutritional factors. The multicomponent nature of the causes and mechanisms of IBS formation play a role also in other functional diseases of the digestive tract, which can lead to a cross-functional pathology in the same patient. As a consequence, the treatment of IBS patients remains a very difficult task, and relapse of the disease depends on the state of the psychoemotional sphere, the presence of comorbidity and the "cross" syndrome. The use of Iberogast ® significantly improved the quality of life of patients with IBS and significantly affected the pain abdominal syndrome, reducing it. The accumulated experience of using Iberogast in the treatment of IBS made it possible to include it in the latest Russian clinical guidelines "Irritable Bowel Syndrome."

Key words: irritable bowel syndrome, Iberogast®, Roman criteria IV, functional gastrointestinal diseases.
For citation: Maev I.V., Cheryomushkin S.V., Kucheryavy Yu.A., Cheryomushkina N.V. Algorithm for managing patients with irritable bowel syndrome. Roman criteria IV // RMJ. 2017. № 10. P. 718–722.