Irritable Bowel Syndrome

Question 1

What is IBS?

Answer 1

Chronic condition of abdo pain and bowel dysfunction +/- bloating. No structural abnormalities to describe pain.

Question 2

Epidemiology of IBS?

Answer 2

-10-20% adults
-Female 2:1 Male
Adolescents - adult. Rare post 50y.

Question 3

What is the aetiology of IBS?

Answer 3

No abnormalities detected. Presumed multifactorial disorder of GIT motility.
May be triggered by stress/emotion.

Question 4

How is IBS classified?

Answer 4

Rome III criteria.

1) IBS with constipation.
2) IBS with diarrhoea
3) Mixed IBS
4) Unspecified IBS

Question 5

What are the key IBS diagnostic factors?

Answer 5

Rome III criteria:

i) Symptoms >3/12
ii) recurrent abdo discomfort ass/w 2+ of:
- improvement of Sx w/ defecation
- change in stool appearance
- change in stool frequency

Question 6

What are the RFx for IBS?

Answer 6

• Physical/sexual abuse

- Age

Question 7

What Ix should be conducted in IBS?

Answer 7

• FBC - normal
• MCS - normal
• Anti-endomysial Abs (-ve i.e. non CD)
• Anti-tTG Abs (-ve i.e. non CD)
• Plain AXR
• Colonoscopy (normal)

Question 8

DDx for IBS?

Answer 8

• Gastroenteritis
• CD/UC
• Food intolerance
• Coeliac disease
• CRC

Question 9

Mx IBS?

Answer 9

• Lifestyle (e.g. assess caffeine/fructose/lactose)
• Reassurance
• Laxative (IBS-C)
• Anti-smasodics (e.g. hyoscyamine)
• Anti-diarrhoeal (loperamide 2-4mg)