Irritable bowel syndrome (IBS)

K58.0/K58.9
(Synonyms: spastic colon, irritable colon)

DESCRIPTION

  • Irritable bowel syndrome consists of a triad of:
  1. abdominal pain and discomfort,
  2. variations in bowel habits from constipation to diarrhoea, and
  3. the passage of small stools at the time abdominal pain is at its worst.
  • The diagnosis is suggested by a protracted and intermittent history of these symptoms which are frequently more pronounced when there is also stress.
  • It is a functional disorder, most often seen in women 15–45 years old.

GENERAL MEASURES

For patients with an established diagnosis:

  • Reassure patient that there is no serious organic disorder.
  • High fibre/bran diets may be tried for patients with constipation.
    • warn about temporary increased flatus and abdominal distension.
    • High fibre/bran diets are not effective for Global IBS (i.e. all symptoms).
  • Dietary advice by dietician.

MEDICINE TREATMENT

  • Not specifically indicated.
  • Based on patients’ predominant symptoms.
  • Short-term symptomatic treatment for diarrhoea and/or constipation.
  • Laxatives only for constipation-specific IBS. See: Constipation.
  • Anti-diarrhoeals only for diarrhoea-specific IBS. See: Diarrhoea.

REFERRAL

  • Blood or mucous in the stool.
  • Weight loss.
  • Age > 50 years of age.