Irritable bowel syndrome

Question 1

What is irritable bowel syndrome?

Answer 1

Group of abdominal symptoms where no organic cause can be found

Question 2

What is the epidemiology of IBS?

Answer 2

Highest age of onset <40yrs

More common in women than men

Question 3

What are the clinical features of IBS?

Answer 3

(Intestinal) Abdominal pain (better after defection)
Altered bowel habit (constipation / diarrhoea)
Nausea + vomiting
(Extra-intestinal) Angular stomatitis, weight loss, fatigue
Normal physical examination

Question 4

How is IBS diagnosed?

Answer 4

(Rome IV criteria) Only diagnose IBS if recurrent abdominal pain + x2 of below:
Pain made better after defecation
Change in stool frequency
Change in stool form

Question 5

What is the treatment of IBS?

Answer 5

(General) High fibre, hydration, avoid gas producing foods + gluten + lactose
(Medical)
For diarrhoea: Antidiarrheals (loperamide),
For constipation: Soluble fibers/bulk‑forming laxatives (psyllium), Osmotic laxatives (polyethylene glycol)
For pain: Antispasmodics (dicyclomine, hyoscyamine)
Tricyclic antidepressants (e.g., amitriptyline, nortriptyline)