Irritable Bowel Syndrome (IBS)

Question 1

What is IBS?

Answer 1

GI tract condition causing abdominal pain, discomfort, bloating, and changing in bowel habit. No abnormality present in GI tract.

Question 2

How is IBS diagnosed?

Answer 2

Rule out other GI diseases, diagnosed by presence of typical symptoms but no general deterioration in patients general well-being.

Question 3

What are the main cause of IBS?

Answer 3

• mobility of the gut
• oversensitive nerves in the gut
• stress/anxiety
• family history
• following illness such as bacterial gastroenteritis
• dietary triggers

Question 4

What are the main symptoms of IBS?

Answer 4

• stomach pain or cramps
• bloating
• diarrhoea, can be sudden
• constipation
• flatulence
• passing mucus in stool
• lethargy
• nausea
• backache

Question 5

What are some advice of managing IBS?

Answer 5

• diet advice
• relaxation advice
• exercise advice

Question 6

What are some pharmacological treatments for IBS?

Answer 6

Aim is symptom control to improve quality of life. Antispasmodics considered to be first line. Two types:
direct acting - mebeverine, alverine, peppermint oil. Relax intestinal smooth muscle directly, useful for abdominal pain and cramping. Very well tolerated. PRN
antimuscarinics - hyoscine butylbromide. Reduces intestinal motility and spasms. Hyoscine has low side effects, less likely to cross blood brain barrier. Poorly absorbed in GI tract. PRN.

Question 7

How can constipation symptoms of IBS be managed?

Answer 7

Laxitives
Lactulose
Linaclotide - considered if others not effective.

Question 8

What drug should be used for diarrhoes symptoms in IBS?

Answer 8

Loperamide

Question 9

What are some further treatment options for IBS?

Answer 9

Tricylic antidepressents can be considered if others not effective. Patient should be regularly monitored due to side effects.