5. Irritable Bowel Syndrome

Question 1

How common is it?

Answer 1

Common (1 in 6)

Question 2

Who does it affect?

Answer 2

3F:1M
All ages, but most first show symptoms before they are 35
Occurs twice as often in those with fibromyalgia, chronic fatigue / back pain, TMJ dysfunction

Question 3

What causes it?

Answer 3

Exact cause is unknown
Strong intestinal contractions cause gas, bloating, diarrhoea
Abnormal discomfort from normal process (nerves)
Inflammation
Can develop after gastroenteritis
Changes in microbiome

Question 4

What risk factors are there?

Answer 4

Family history
Female
Mental health disorder eg anxiety, depression

Question 5

How does it present?

Answer 5

Diarrhoea, constipation
Abdo pain
Excessive gas
Fatigue

Question 6

What signs might the patients have on examination?

Answer 6

Mucus in stool
Abdo distension, tenderness
If severe diarrhoea: postural hypotension, low bp, tachycardia

Question 7

What other conditions might present similarly?

Answer 7

IBD

Coeliac disease

Question 8

How would you investigate?

Answer 8

Stool sample
FBC
Abdo exam

Question 9

What treatments are there?

Answer 9

Lifestyle modification - fresh food, exercise, eat regularly
Manage stress / underlying mental health issues
Laxatives