Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a common gut condition which can affect about one in ten people.

It is most common among people aged between 25 and 45 but can cause problems at any age.

Women tend to be affected more than men.

 

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Symptoms of Irritable Bowel Syndrome (IBS)

For a diagnosis of Irritable Bowel Syndrome (IBS), patients should report the following (ABC) for at least 6 months:

  • Abdominal pain/ discomfort
  • Bloating
  • Change in bowel habit

Referral for further investigation is necessary if any of the following are present:

  • Unintentional / unexplained weight loss
  • Rectal bleeding
  • Family history of bowel cancer or ovarian cancer
  • Change in bowel habit to looser / more frequent stools for more than 6 weeks in patients over 60 years of age
  • Anaemia
  • Abdominal masses
  • Rectal masses
  • Raised inflammatory markers (suggestive of inflammatory bowel disease)

The abdominal pain / discomfort should be relieved by defaecation or associated with altered bowel habit or stool form. Furthermore, the abdominal pain / discomfort may also be accompanied by the following:

  • Altered stool passage (straining, urgency, incomplete evacuation)
  • Abdominal bloating
  • Symptoms become worse by eating
  • Passage of mucus

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How is Irritable Bowel Syndrome (IBS) investigated?

The following investigations are required in patients to eliminate other causes:

  • Full blood count (FBC)
  • ESR (Erythrocyte sedimentation rate) and CRP (C-Reactive Protein) bloods test to detect inflammation
  • Antibody testing for coeliac disease

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Treatment for Irritable Bowel Syndrome (IBS)

The following treatments are available for Irritable Bowel Syndrome:

  • Patients diagnosed with IBS are encouraged to incorporate relaxation time into their daily lives as well as increasing their levels of physical activity

  • Have regular meals and take time to eat.
  • Drink 8 cups of fluid and limit caffeinated drinks to 3 cups a day.
  • Reduce fizzy drink intake and alcohol.
  • Avoid sorbitol (which is also referred to as also known as glucitol). This is a sugar alcohol that the human body metabolizes slowly. Sorbitol is found in apples, pears, peaches, and prunes.
  • Reduce fibre intake although people with bloating and wind may benefit from soluble fibre (ispaghula / oats / linseeds).
  • Referral to a dietician may be required.

  • The possible prescription of anti-spasmodics drugs that relaxes muscle contractions reduces cramps or spasms in the stomach, large intestine and bladder.
  • Laxatives for constipation symptoms (avoid lactulose), loperamide for diarrhoeal symptoms.
  • Low-dose tri-cyclic antidepressants if anti-spasmodics, laxatives and anti-diarrhoeals have not worked.
  • Consider psychological therapies for sufferers who do not respond to the above after 12 months.

For information on the NICE Guidelines about the misdiagnosis of Irritable Bowel Syndrome, click here.

What are the next steps?

If you think you have this condition or any of these symptoms you will need to seek medical advice.

For more information or to make an appointment:

If you have private medical care or wish to pay to see a consultant:

Take this factsheet along to your own GP and request a referral to one of our consultants.