IBS (irritable bowel syndrome)

Question 1

What is IBS?

Answer 1

IBS (irritable bowel syndrome) is defined as a chronic, functional bowel disorder in which abdominal pain is associated with intermittent diarrhoea, sometimes alternating with constipation, and a feeling of abdominal distension

Question 2

Define abdominal distention

Answer 2

Abdominal distension occurs when substances, such as air (gas) or fluid, accumulate in the abdomen causing its outward expansion beyond the normal girth of the stomach and waist.

Question 3

Treatment timescale of IBS

Answer 3

With treatment should resolve within 1 week but can go on for months or years

Question 4

Symptoms of IBS

Answer 4

• abdominal pain- anywhere in the abdomen, relieved by defecating
• bloating
• bowel habit change: can be either diarrhoea or constipation, incomplete emptying, semi-formed stools, can have mucus in it , NOT blood
• nausea
• lethargy
• urinary symptoms

Question 5

IBS referral criteria

Answer 5

• unexplained weight loss
• child under 16 presenting with symptoms
• blood in stools
• patient with no previous history of IBS and no precipitating factors
• failed treatment
• nausea and/or vomiting
• patients aged 45+ with no previous history of canged habit
• unresponsive to treatment

Question 6

Lifestyle advice for IBS

Answer 6

If diarrhoea occurs: eat less fibre
if constipation: eat more fibre
Bloating: eat insoluble fibre e.g. bran
Exclude food that can exacerbate IBS like sweeteners (sorbitol and fructose), caffeine and dairy products 
risk of dehydration - maintain fluids

Question 7

Name 4 treatments licensed for IBS

Answer 7

Imodium IBS
Mebeverine hydrochloride
Alverine citrate 60mg (spasmadol)
Peppermint oil (Colpermin IBS relief)

Question 8

Immodium IBS
Symptoms
directions for use
warnings

Answer 8

Diarrhoea
2 capsules followed by 1 capsule every loose bowel movement
max 6 capsules in 24 hours
warning: not for use in under 18s

Question 9

Mebeverine hydrochloride

Directions for use

Answer 9

1 tablet TDS for treatment of IBS

Question 10

Mebeverine hydrochloride

side effects

Answer 10

Heartburn
Nausea and Vomiting
Allergic reaction 
Anal irritation 
Mouth burning

Question 11

Mebeverine hydrochloride

warnings

Answer 11

Not to use in under 15yrs
Do NOT use in pregnancy or breastfeeding
Contains peanut and soya - ask about allergies

Question 12

Mebeverine hydrochloride counselling

Answer 12

contains peanut and soya
do not chew
do not take after food
can be used for long term but only after doctor consultation

Question 13

Alverine citrate 60mg (Spasmadol) for IBS

Directions for use

Answer 13

1-2 capsules TDS

Question 14

Alverine citrate 60mg (Spasmadol) for IBS

side effects

Answer 14

shortness of breath 
yellowing of eyes and teeth 
Nausea
Dizziness
Headache
Rashes

Question 15

Alverine citrate 60mg (Spasmadol) for IBS

warnings

Answer 15

Not for those under 12yrs of age
Do not take if pregnant or breastfeeding
Do not take if have dangerous symptoms

Question 16

Alverine citrate 60mg (Spasmadol) for IBS

counselling

Answer 16

Can take with or without food
Do not chew
Take with plenty of water