IBS

Question 1

Irritable Bowel Syndrome (IBS)

Answer 1

Irritable bowel syndrome (IBS) is a disorder that leads to abdominal pain and cramping, changes in bowel movements, and other symptoms.

In IBS, the structure of the bowel is not abnormal.

Question 2

Aetiology and pathophysiology of IBS

Answer 2

Aetiology

Causes not fully understood but its thought many factors are involved including:

• gut hypersensitivity
• low-grade mucosal inflammation
• disturbed colonic motility
• previous gastrointestinal infection
• psychological factors
• changes in the Microbiome

The pathophysiology of IBS is broad and includes abnormalities involving motility, visceral sensation, brain-gut interaction, and psychosocial distress.

Question 3

Diagnosis

Answer 3

According to NICE (2008) A diagnosis of IBS should be considered only if the person has abdominal pain or discomfort that is either relieved by defaecation or associated with altered bowel frequency or stool form. This should be accompanied by at least 2 of the following 4 symptoms:

• altered stool passage (straining, urgency, incomplete evacuation)
• abdominal bloating (more common in women than men), distension, tension or hardness
• symptoms made worse by eating
• passage of mucus.

In people who meet the IBS diagnostic criteria, the following tests should be undertaken to exclude other diagnoses:

• full blood count (FBC)
• erythrocyte sedimentation rate (ESR) or plasma viscosity
• c‑reactive protein (CRP)
• antibody testing for coeliac disease (endomysial antibodies [EMA] or tissue transglutaminase [TTG]).