Irritable bowel syndrome

Question 1

What is the definition of irritable bowel syndrome?

Answer 1

A mix of various abdominal symptoms with no organic causes

Question 2

What is the pathology of irritable bowel syndrome?

Answer 2

• ?Disorder of intestinal motility

* ?Enhanced visceral perception

Question 3

What are the risk factors/aetiology of irritable bowel syndrome?

Answer 3

• Stress/anxiety
• Female
• Infectious diarrhoea

Question 4

What are the signs/symptoms of irritable bowel disease?

Answer 4

• Diagnosis based on within the last 3 months there should be 3 days per month of recurrent abdominal pain with 2 or more of the following symptoms:
• Abdominal pain/bloating – relieved by defecation
• Onset associated with altered stool/bowel frequency – including mucus
• Constipation/diarrhoea
• Co-exists with chronic fatigue syndrome, fibromyalgia and temporomandibular joint dysfunction

Question 5

What other conditions present similarly to irritable bowel disease?

Answer 5

• Inflammatory bowel disease

* Diverticulitis

Question 6

What investigations are carried out for suspected irritable bowel disease?

Answer 6

• Bloods – FBC, ESR, CPR, LFT, coeliac serology
• Colonscopy/edoscopy/biopsy
• PR examination

Question 7

What are the surgical treatments for irritable bowel syndrome?

Answer 7

None

Question 8

What are the pharmacological treatments for irritable bowel syndrome?

Answer 8

• Bisacodyl – constipation
• Loperamide – diarrhea
• Mebeverine/alverine/simethicone/hyoscine – antispasmodic
• Antidepressants

Question 9

What are the non- pharmacological treatments for irritable bowel syndrome?

Answer 9

• Change in diet – avoiding trigger foods
• Peppermint
Prebiotics/probiotics
• Hypnotherapy, CBT, psychotherapy