Irritable Bowel Syndrome

Question 1

What is irritable bowel syndrome?

Answer 1

Group of abdominal symptoms with no organic cause. Most due to disorders of intestinal mobility or microbial dysbiosis.

Question 2

What is the typical age and gender of someone with IBS?

Answer 2

40 years or under, female 2x as likely.

Question 3

What is this a presentation of?
Urgency, incomplete evacuation, abdominal bloating/distension, mucus PR, worsening of symptoms after food. Chronic (>6 months), exacerbated by stress, menstruation, or gastroenteritis. No organic cause found.

Answer 3

Irritable bowel syndrome

Question 4

How is irritable bowel syndrome investigated?

Answer 4

1. If history classic - FBC, ESR, CRP, coeliac screen sufficient for diagnosis.
2. If >60, pyrexia, blood PR, weight loss - colonoscopy
3. Low threshold for referral if FHx of ovarian/bowel cancer
4. Faecal calprotectin can distinguish from IBD

Question 5

What is the criteria for diagnosing irritable bowel syndrome?

Answer 5

Recurrent abdominal pain associated with at least 2 of:

1. Relief by defecation
2. Altered stool form
3. Altered bowel frequency (alternative constipation and diarrhoea)

Question 6

What is the treatment for irritable bowel syndrome?

Answer 6

1. Lifestyle/dietary measures, cognitive/pharmacotherapy
2. Constipation - water, fibre, exercise, laxative
3. Diarrhoea - avoid triggers, loperamide
4. Bloating/colic - antispasmodics, probiotics