What is IBS?
Denotes a mixed group of abdominal symptoms for which no organic cause can be found.
What are the 3 types of IBS?
- IBS-C : with constipation
- IBS-D : with diarrhoea
- IBS-M : with constipation and diarrhoea
What are the risk factors of IBS?
- Age of onset under 40
- Females > males
- Stress
- Menstruation
- Depression and anxiety
- Psychological stress and trauma
- GI infection
- Sexual, physical or verbal abuse
- Eating disorders
What are the symptoms of IBS?
- Abdominal pain or discomfort (relieved by defecation)
- Bloating
- Change in bowel habit
- Painful period
- Back pain
- Fatigue
- Nausea
- Symptoms worsen after food
What are the main differences between IBS and IBD?
- IBS has normal investigation results whereas IBD doesn’t
- IBS no blood in stool and, no mcleans, no weight loss and no mouth ulcers
What are the similarities between IBS and IBD?
- Persistant and fluctuating symptoms
- Triggered by food
What investigations would you do for IBS?
As there is nothing physical to be found, the diagnosis is mainly made by ruling out the differentials
What is the treatment for mild IBS?
- Education,
- Reassurance
- Dietary modification
What is the treatment for moderate IBS?
- Pharmacotherapy
- Psychological treatment
What is the treatment for severe IBS?
Referral to pain treatment centre
What is the non-pharmalogical treatment for IBS?
- Low FODMAP diet
- Regular or small frequent meals
- Plenty of fluid
- IBD - insoluble fibre
- For wind and bloating - soluble fibre
- Reduce caffeine, alcohol, fizzy drinks etc.
What is the pharmacological treatment for Pain and bloating?
Antispasmodics e.g buscopan
What is the treatment for constipation?
Laxitives e.g movicol
What is the treatment for Diarrhoea?
Anti-motility agents
What condition is associated with IBS and could therefore be treated?
Anxiety and depression so SSRI’s could be used.