Consensus Panel Defines Patient-Centered Treatment Response to IBS-C
Key Clinical Summary
- A 2-round modified Delphi process evaluated 16 statements on assessing treatment response in irritable bowel syndrome with constipation (IBS-C).
- Fourteen statements achieved the prespecified consensus threshold of at least 80% agreement.
- Experts recommended evaluating bowel and abdominal symptoms, health-related quality of life (HRQoL), treatment satisfaction, adverse effects, patient preferences, and expectations.
A US-based expert panel developed consensus recommendations for evaluating treatment response in patients with IBS-C, according to a study published online in Clinical and Translational Gastroenterology. The recommendations emphasize comprehensive, patient-centered assessment while identifying the need for practical standardized tools to support treatment decisions and reduce variability in IBS-C management.
Study Findings
IBS-C is a disorder of gut-brain interaction characterized by constipation and abdominal symptoms that can adversely affect HRQoL. The investigators noted that best practices for modifying treatment based on patient response remain undefined, contributing to inconsistent clinical management.
The researchers conducted a 2-round modified Delphi panel involving US healthcare professionals experienced in IBS-C. Participants rated 16 statements covering symptom assessment, treatment response, HRQoL, treatment-related adverse effects, patient satisfaction, and treatment decisions using a 5-point Likert scale.
Fourteen statements ultimately reached consensus. The recommendations called for integrating assessments of both bowel and abdominal symptoms rather than evaluating either symptom domain alone.
Panelists also supported documenting the severity of patients’ most bothersome symptoms before treatment. Other recommended considerations included the effects of IBS-C on HRQoL and patients’ satisfaction with treatment.
Although the panel favored standardized measures for assessing therapeutic response in clinical practice, participants did not consistently recommend any specific instrument. Treatment decisions were also influenced by the balance between benefits and adverse effects, patient preferences and expectations, clinicians’ familiarity with therapies, and shared decision-making.
Clinical Implications
The recommendations provide a multidimensional approach to IBS-C treatment-response assessment. Under this framework, clinicians consider changes in constipation and abdominal symptoms alongside HRQoL, treatment tolerability, and patient satisfaction.
Baseline assessment of the patient’s most bothersome symptoms may help establish what should be reevaluated after treatment begins. The consensus also places patient preferences and expectations within the treatment decision process and supports discussing therapeutic benefits and adverse effects through shared decision-making.
However, the study did not identify a single standardized response measure that panelists consistently endorsed. The authors therefore highlighted the continuing need for practical tools that can support individualized treatment decisions and reduce variability in clinical management.
The modified Delphi recommendations define treatment response in IBS-C as broader than bowel-frequency improvement alone. Further development of practical standardized measures remains necessary to translate the panel’s patient-centered framework consistently into clinical practice.
Reference
Sayuk GS, Filipenko D, Kornalska K, Swinburn P, Chang L. Assessing treatment response in patients with IBS-C in clinical practice: consensus expert recommendations using a modified Delphi process. Clin Transl Gastroenterol. Published online August 19, 2026. doi:10.14309/ctg.0000000000001086
