Essential reading from the editor’s desk

As the national Belgian journal for gastroenterology and hepatology, one of the missions of the Acta Gastro- enterologica Belgica is to provide guidelines on the diagnosis and treatment of a variety of gastrointestinal disorders to our readership. In the past years we have published excellent practical Belgian national guidelines on the management of gastro-pancreatic neuro-endocrine tumors (1), pathology of colorectal polyps (2) and hemorrhoids (3). In the current issue of the Acta we are proud to publish the Belgian consensus guidelines on irritable bowel syndrome (IBS) (4). A group of 20 national experts have summarized the literature on 78 statements related to the definition, pathophysiology, diagnosis and treatment of IBS, followed by voting rounds in a Delphi consensus approach. The expert groups reached consensus on 50 statements with important guidance for practicing clinicians. In the absence of alarm signs and symptoms the group advices against performing a colonoscopy or additional testing besides a limited set of blood tests and fecal calprotectin. Lifestyle modification, water soluble fiber and spasmolytics agents are considered first line treatments, with specific probiotics, low FODMAP diet and psychological treatments as alternatives. A group of pediatric gastroenterologists was invited to highlight similarities and discrepancies in diagnosis and treatment in children, which is also published in this issue (5). We are confident that both consensus documents will serve as a guidance for adult and pediatric gastroenterologists in the care of this common but often difficult to treat condition. We also invite other Belgian societies to organize consensus groups and develop Belgian guide- lines, which can be published in our journal.

Keywords: Irritable bowel syndrome, metabolic dysfunction associated liver disease, MAFLD, malnutrition, adenoma detection rate.