Irritable Bowel Syndrome

Question 1

What is IBS

Answer 1

A group of abdominal symptoms for which no organic cause can be found

Question 2

What are most due to

Answer 2

Disorders of intestinal motility or enhanced visceral perception

Question 3

Psychological causes

Answer 3

Stress, anxiety, depression

Question 4

When to diagnose IBS

Answer 4

Only if abdominal pain is either relieved by defecation OR associated with altered stool frequency / form

AND there are 2 or more of

Urgency 
Incomplete evacuation 
Abdominal bloating / distension 
PR mucous 
Worsening of symptoms after food

Question 5

Other Chronic (>6months) Symptoms

Answer 5

Nausea
Bladder symptoms
Backache

Question 6

How may symptoms be exacerbated

Answer 6

Stress
Menstruation
Gastroenteritis

Question 7

Signs

Answer 7

Examination often normal

General abdominal tenderness common

Question 8

Management

Answer 8

Explanation and reassurance

Dietetic Review

Question 9

Diet advice

Answer 9

Healthy diet

Fibre, lactose, fructose, wheat, starch, caffeine, sorbitol, alcohol and fizzy drinks may worsen symptoms

Question 10

Further Treatment

Answer 10

Depends on which symptoms predominate

Pain - antispasmodic, antidepressant
Bloating - probiotics
Constipation - laxatives
Diarrhoea - bulking agent

Question 11

Psychological Interventions

Answer 11

CBT

Hypnosis