TY - JOUR T1 - Highlights from this issue JF - Frontline Gastroenterology JO - Frontline Gastroenterol SP - 261 LP - 262 DO - 10.1136/flgastro-2021-101923 VL - 12 IS - 4 AU - R Mark Beattie Y1 - 2021/07/01 UR - http://fg.bmj.com/content/12/4/261.abstract N2 - Irritable bowel syndrome is common and can have a considerable impact on quality of life. Early diagnosis and timely and evidence based management is key to improved outcomes and best management. Consideration of the differential diagnosis is important. Christopher Black and Alexander Ford have previously written for us on rational and appropriate investigation.1 In this issue the authors cover ‘Best Management’. Multiple different treatment options are discussed including anti-spasmodics, peppermint oil, neuromodulators and tricyclics. There is a strong focus on good communication and holistic care and setting realistic expectations of treatment. Simple lifestyle and dietary strategies are important. A low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) can be considered providing dietetic support is available. Patients with constipation resistant to laxatives should be offered a trial of linaclotide. For patients with diarrhoea that fails to respond to loperamide alosetron and ramosetron can be considered. For patients who are symptomatic with significant impact on their functioning cognitive behavioural therapy and gut directed hypnotherapy should be considered both of whom have a reasonable evidence base. Refractory IBS can be very challenging. This is an excellent review of the best available treatment options – evidence based, focused and practical for implementation by the busy clinician. Listen to the linked Podcast. Editor’s Choice this month (See page 303) .Iron deficiency anaemia is common in gastroenterological disorders including inflammatory bowel disease although not always straightforward to treat particularly in the context of … ER -