title: The Mexican consensus on irritable bowel syndrome.
abstract: BACKGROUND
  Since the publication in 2009 of the Guidelines on the Diagnosis and Treatment of Irritable Bowel Syndrome of the Asociación Mexicana de Gastroenterología (2009 Guidelines), there have been significant advances in our knowledge of the epidemiology, pathophysiology, diagnosis, and treatment of this disease.
  
  
  OBJECTIVE
  To present a consensus review of the most current knowledge of IBS, updating the 2009 Guidelines by incorporating new internationally published scientific evidence, with a special interest in Mexican studies.
  
  
  METHODS
  The PubMed literature from January 2009 to March 2015 was reviewed and complemented through a manual search. Articles in English and Spanish were included and preference was given to consensuses, guidelines, systematic reviews, and meta-analyses. Statements referring to the different aspects of the disease were formulated and voted upon by 24 gastroenterologists employing the Delphi method. Once a consensus on each statement was reached, the quality of evidence and strength of recommendation were determined through the GRADE system.
  
  
  RESULTS
  Forty-eight statements were formulated, updating the information on IBS and adding the complementary data that did not appear in the 2009 Guidelines regarding the importance of exercise and diet, diagnostic strategies, and current therapy alternatives that were analyzed with more stringent scientific vigor or that emerged within the last 5 years.
  
  
  CONCLUSIONS
  We present herein a consensus review of the most relevant advances in the study of IBS, updating and complementing the 2009 Guidelines. Several studies conducted in Mexico were included.
authors.affiliation: Práctica privada, San Luis Potosí, S.L.P., México. Electronic address: rcarmonas1@prodigy.net.mx.
authors.forename: R
authors.initials: R
authors.lastname: Carmona-Sánchez
authors.affiliation: Hospital Star Médica de Mérida, Mérida, Yucatán, México.
authors.forename: M E
authors.initials: ME
authors.lastname: Icaza-Chávez
authors.affiliation: Unidad de Pacientes en Estudio, Universidad Autónoma de Guadalajara, Zapopán, Jalisco, México.
authors.forename: M V
authors.initials: MV
authors.lastname: Bielsa-Fernández
authors.affiliation: Clínica de Gastroenterología, Endoscopia Digestiva y Motilidad Gastrointestinal, Hospital Ángeles Puebla, Puebla, Puebla, México.
authors.forename: O
authors.initials: O
authors.lastname: Gómez-Escudero
authors.affiliation: Facultad de Medicina, Universidad Autónoma de Nuevo León. División de Medicina Interna, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo León, México.
authors.forename: F
authors.initials: F
authors.lastname: Bosques-Padilla
authors.affiliation: Departamento de Gastroenterología y Laboratorio de Motilidad Gastrointestinal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, México.
authors.forename: E
authors.initials: E
authors.lastname: Coss-Adame
authors.affiliation: Servicio de Endoscopia, Hospital General Dr. Miguel Silva, SSM, Morelia, Michoacán, México.
authors.forename: F
authors.initials: F
authors.lastname: Esquivel-Ayanegui
authors.affiliation: Servicio de Gastroenterología y Endoscopia Digestiva, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado y Municipios de Baja California, ISSSTECALI, Hospital Mexicali, Mexicali, Baja California Norte, México.
authors.forename: Á R
authors.initials: ÁR
authors.lastname: Flores-Rendón
authors.affiliation: Laboratorio de Motilidad Gastrointestinal, Departamento de Endoscopia, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México.
authors.forename: M A
authors.initials: MA
authors.lastname: González-Martínez
authors.affiliation: Servicio de Endoscopia y Fisiología Digestiva, Hospital Ángeles Torreón, Torreón, Coahuila, México.
authors.forename: F
authors.initials: F
authors.lastname: Huerta-Iga
authors.affiliation: Servicio de Educación e Investigación en Salud, UMAE Hospital de Especialidades, CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, Puebla, México.
authors.forename: A
authors.initials: A
authors.lastname: López-Colombo
authors.affiliation: Servicio de Gastroenterología, Hospital Ángeles Xalapa, Xalapa, Veracruz, México.
authors.forename: T H
authors.initials: TH
authors.lastname: Méndez-Gutiérrez
authors.affiliation: Departamento de Enseñanza e Investigación, Hospital Español de México, Ciudad de México, México.
authors.forename: A
authors.initials: A
authors.lastname: Noble-Lugo
authors.affiliation: Práctica privada, Irapuato, Guanajuato, México.
authors.forename: J R
authors.initials: JR
authors.lastname: Nogueira-de Rojas
authors.affiliation: Servicio de Gastroenterología, Hospital Español de México, Ciudad de México, México.
authors.forename: R H
authors.initials: RH
authors.lastname: Raña-Garibay
authors.affiliation: Laboratorio de Motilidad y Fisiología Digestiva, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, México.
authors.forename: J M
authors.initials: JM
authors.lastname: Remes-Troche
authors.affiliation: Departamento de Gastroenterología, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Veracruz, México.
authors.forename: F
authors.initials: F
authors.lastname: Roesch-Dietlen
authors.affiliation: Laboratorio de Hígado, Páncreas y Motilidad, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México. Hospital General de México, Ciudad de México, México.
authors.forename: M J
authors.initials: MJ
authors.lastname: Schmulson
authors.affiliation: Servicio de Gastroenterología y Endoscopia GI, Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos y Clínica de Fisiología Digestiva del Hospital Ángeles Metropolitano, Ciudad de México, México.
authors.forename: J C
authors.initials: JC
authors.lastname: Soto-Pérez
authors.affiliation: Servicio de Gastroenterología y Endoscopia GI, Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa, Hospital Civil de Culiacán, Culiacán, Sinaloa, México.
authors.forename: J L
authors.initials: JL
authors.lastname: Tamayo
authors.affiliation: Departamento de Gastroenterología, INCMNSZ, Ciudad de México, México.
authors.forename: L F
authors.initials: LF
authors.lastname: Uscanga
authors.affiliation: Departamento de Gastroenterología, INCMNSZ, Ciudad de México, México.
authors.forename: M Á
authors.initials: MÁ
authors.lastname: Valdovinos
authors.affiliation: Departamento de Enseñanza, Hospital de Alta Especialidad de Veracruz-SESVER. Cátedra de Gastroenterología y Enfermedad Quirúrgica, Facultad de Medicina Campus Veracruz, Universidad Veracruzana, Veracruz, México.
authors.forename: J
authors.initials: J
authors.lastname: Valerio-Ureña
authors.affiliation: Programa de Doctorado en Ciencias Médicas, Unidad de Posgrado, Universidad Nacional Autónoma de México. Departamento de Gastroenterología INCMNSZ, Ciudad de México, México.
authors.forename: M R
authors.initials: MR
authors.lastname: Zavala-Solares
mesh_terms: D003697:Delphi Technique; D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000628:therapy*; D008800:Mexico
keywords: Consenso; Consensus; Diagnosis; Diagnóstico; Irritable bowel syndrome; Mexico; México; Review; Revisión; Síndrome de intestino irritable; Tratamiento; Treatment