IRRITABLE BOWEL SYNDROME: CLINICAL EVALUATION AND SURGICAL POSSIBILITIES

Abstract

Irritable Bowel Syndrome (IBS) is a gastrointestinal condition that significantly affects the quality of life of millions of people around the world. Characterized by symptoms such as abdominal pain, bloating, diarrhea and constipation, IBS is a complex and multifactorial condition whose exact etiology is still subject to study. Its diagnosis largely depends on clinical assessment of symptoms and ruling out other medical conditions. Clinical assessment of IBS plays a key role in identifying the condition and establishing guidelines for appropriate treatment. However, in severe and refractory cases, the possibility of surgical interventions is considered a last resort to improve patients' quality of life. Objective: to explore advances in the field of clinical assessment of IBS and the surgical possibilities available for its management. Methodology: based on the PRISMA Checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the databases included PubMed, Scielo and Web of Science, we used the following descriptors in English: "Irritable Bowel Syndrome", "Clinical Assessment" , "Surgical Options", "Gastrointestinal Surgery", and "Treatment Outcomes". Inclusion criteria: Studies published in English or Portuguese, randomized clinical studies, controlled clinical trials, systematic reviews. The exclusion criteria were as follows: Studies that did not fit the inclusion criteria mentioned above, studies with insufficient methodological quality or incomplete reports that did not allow for an adequate assessment. Results: 12 articles were selected. The studies reviewed highlighted the importance of a detailed clinical assessment for the diagnosis and management of IBS. This included consideration of diagnostic criteria, exclusion of other gastrointestinal conditions, and assessment of patients' symptoms and quality of life. Conventional therapy, including dietary modifications, stress management, and medication use, has been identified as the first line of treatment for IBS. For patients who did not obtain adequate relief from conventional therapeutic approaches, surgical options were considered. Surgery may be a viable alternative for severe and refractory cases of IBS, although it is reserved for specific situations. Conclusion: The systematic review highlights the complexity of Irritable Bowel Syndrome and the need for individualized treatment approaches. Careful clinical assessment and conventional therapeutic options remain essential, with surgery playing a restricted role in specific and severe cases. The choice between therapeutic options must be made considering the benefits and risks for each patient, with an emphasis on improving quality of life and relieving symptoms.