Treatment of Irritable Bowel Syndrome With Antispasmolytics in Taiwan, Hong Kong, and Vietnam: A Delphi Expert Consensus Statement

In Hong Kong, Taiwan and Vietnam, the burden of irritable bowel syndrome (IBS) is poorly documented, with limited evidence-based treatments and outdated guidelines. We used a modified Delphi method to reach expert consensus on different aspects of disease management and gain insights into the current clinical practice for IBS in these 3 countries, focusing on treatment with antispasmolytics. Evidence from a targeted literature review was used to draft consensus statements for a multidisciplinary 3-round Delphi survey. Consensus was defined as ≥ 70% agreement among experts from the same country (qualitative data) or a SD < 5% on rate estimates (quantitative data). Data were grouped and analyzed by expert specialty and country. Thirty-six experts (12 per country; primary care physicians, n = 6; gastroenterologists, n = 4; and pharmacists, n = 2) participated in the 3 voting rounds. Consensus was reached for 17/25 (68.0%) statements. Respondents agreed that IBS diagnosis relies on symptoms and guidelines. Regarding antispasmolytics, most experts were highly satisfied with the available medications, particularly hyoscine and otilonium bromide, and agreed on a short (< 2 weeks) treatment duration. Mean 1-year relapse rate was 38.3-48.0% with antispasmolytics overall and 20.5-26.5% with otilonium bromide. In all 3 countries, consensus was reached that frequent IBS relapses affect patients' daily routine and quality of life frequently and that long-term treatment strategies addressing relapse represent a key unmet need in IBS management. Although antispasmolytics provide immediate symptom relief, their long-term effectiveness needs further investigations in Asian populations. Our findings may inform clinical decision-making and guideline updates.