Irritable Bowel Syndrome (IBS)

Question 1

What is IBS?

Answer 1

chronic condition characterised by abdominal pain associated with bowel dysfunction

Question 2

What is typical epid for IBS

Answer 2

10-15% of population, mostly female and less than 50yo

Question 3

What are the risk factors for IBS?

Answer 3

1. Women
2. <50 years old
3. Previous enteric infection
4. History of physical or sexual abuse

Question 4

What are symptoms or signs of IBS?

Answer 4

1. Abdominal discomfort (generalised cramping)
2. Alteration of bowel habits associated with pain: relief when passed
3. Abdominal bloating or distension: improves with passing stool or flatus
4. Normal examination of abdomen

Question 5

What are potential differential diagnosis of IBS?

Answer 5

1. Crohn’s disease
2. Ulcerative colitis
3. Lymphocytic and collagenous colitis (microscopic colitis)
4. Coeliac disease
5. Colon cancer
6. Bowel infections
7. Non-coeliac gluten sensitivity
8. Bile acid malabsorption
9. Small bowel bacterial overgrowth

Question 6

What is the 1st line investigation for IBS?

Answer 6

FBC

Question 7

What does FBC show?

Answer 7

normal; anaemia suggests non-IBS disease

Question 8

What other investigations may you do?

Answer 8

-exclude IBD, coleiac and colonic cancer

Question 9

What is key symptoms of iBS?

Answer 9

Defecation RELIEVES abdominal pain/discomfort (good q for gastro history)

Question 10

What are 3 different types of IBS?

Answer 10

IBS-D: IBS with diarrhoea
IBS-C: IBS with constipation
IBS-M: IBS mixed type

Question 11

What is the lifestyle management of IBS?

Answer 11

• Fibre
• Avoid: caffeine, lactose, fructose.
• Stress management
• Education + Reassurance
• • Probiotics ?

Question 12

What is the medical management of IBS?

Answer 12

• Laxatives (IBS-C)
• Antispasmotics (cramps)
• Antidiarrhoeals (IBS-D)