IBS

Question 1

what is irritable bowel syndrome (IBS)?

Answer 1

a chronic, relapsing disorder characterised by the presence of abdominal pain or discomfort, which may be associated with defaecation and/or accompanied by a change in bowel habit

Question 2

what are the risk factors for IBS?

Answer 2

• genetic
• female
• young
• stress
• anxiety

Question 3

when should a diagnosis of IBS be considered?

Answer 3

if a person has abdominal pain or discomfort that is:
- relieved by defecation
- associated with altered bowel frequency or stool form

plus at least two of the following:
- altered stool passage (straining, urgency, incomplete evacuation)
- abdominal bloating, distension, tension, or hardness
- symptoms worsened by eating
- passage of mucus

Question 4

what investigations should be undertaken to exclude other diagnoses in IBS?

Answer 4

• FBC
• ESR/CRP
• EMA/tTG
• calprotectin

Question 5

what is the dietary management of IBS?

Answer 5

low-FODMAP diet

Question 6

what is the medical management of IBS?

Answer 6

• anti-diarrhoeal (e.g. loperamide, cholestyramine)
• laxative (e.g. prucalopride, linaclotide)
• antispasmodic
• low-dose tricyclic antidepressant (e.g. amitriptyline)
• SSRI