IBS

Question 1

What is Irritable Bowel Syndrome (IBS)?

Answer 1

A chronic functional disorder of the gastrointestinal tract, characterised by recurrent abdominal pain and altered bowel habits.

IBS is a common condition that affects the large intestine.

Question 2

What is the triad of symptoms for IBS diagnosis?

Answer 2

Abdominal pain, Bloating, Change in bowel habit.

Symptoms must be present for at least 6 months.

Question 3

What specific symptom is associated with abdominal pain in IBS?

Answer 3

Relieved by defecation.

This symptom is a key feature in the diagnosis of IBS.

Question 4

List some specific symptoms of IBS.

Answer 4

• Abdominal pain relieved by defecation
• Altered bowel frequency
• Altered stool passage (straining, urgency)
• Abdominal bloating, distention, hardness
• Symptoms made worse by eating
• Passage of mucus

These symptoms can vary in intensity among individuals.

Question 5

What are some non-specific symptoms of IBS?

Answer 5

• Fatigue
• Nausea
• Backache
• Bladder symptoms

Non-specific symptoms may not be directly related to gastrointestinal issues.

Question 6

What investigations are typically done in primary care for IBS?

Answer 6

• FBC
• CRP
• Coeliac screen (TTG - tissue transglutaminase antibodies)

Diagnosis is often by exclusion of other conditions.

Question 7

What is the first line management for IBS based on the dominant symptom?

Answer 7

• Good hydration
• Low FODMAP diet
• Antispasmotic agent for pain
• Laxatives for constipation - Linaclotide (avoid lactulose)
  *** Loperamide **for diarrhoea

Management strategies may vary depending on the patient’s primary symptoms.

Question 8

What is a second line management option for IBS?

Answer 8

Low-dose tricyclic antidepressants (TCA) such as Sertraline or Amitriptyline (5-10mg).

These medications can help with pain and overall symptoms.

Question 9

What are some alternative management options for IBS?

Answer 9

• Psychological interventions (stress management)
• Complementary and alternative medicines (CAMs)

Psychological factors can significantly impact IBS symptoms.

Question 10

What general dietary advice is recommended for IBS management?

Answer 10

• Eat meals more regularly
• Take time to eat and avoid missing meals
• Increase fluid intake (limit caffeine, alcohol, fizzy drinks)
• Limit fresh fruit, UPF, high-fibre foods
• For wind/bloating, eat more oats

Dietary changes can greatly improve symptoms.