This document provides information about irritable bowel syndrome (IBS), including its pathophysiology, diagnosis, signs and symptoms, and treatment. IBS is classified as a functional disorder caused by altered gastrointestinal function rather than structural issues. It is related to visceral hypersensitivity and abnormal bowel motility. Diagnosis involves reviewing symptoms and ruling out other conditions through tests. Signs include abdominal pain, changes in bowel habits, bloating and gas. Treatment focuses on dietary changes like reducing trigger foods, stress management techniques, fiber intake, and medications in some cases.

1. IRRITABLE
BOWEL
SYNDROME

2. TOPIC OUTLINE

3. INTRODUCTION
IBS is sometimes referred to as spastic colon, mucous colitis,
spastic colitis, nervous stomach, or irritable colon. It is
generally classified as a “functional” disorder, i.e. a disease
where the primary abnormality is an altered physiological
function, rather than an identifiable structural or biochemical
cause.

4. PATHOPHYSIOLOGY

5. PATHOPHYSIOLOGY
Underlying pathology is still not well understood but seems to be
related to:
Visceral Hypersensitivity: Increased sensitivity to pain in the
gastrointestinal tract. Normal sensations like gas or stool passing through
the intestines may be perceived as painful.

7. PATHOPHYSIOLOGY
Underlying pathology is still not well understood but seems to be
related to:
Abnormal Bowel Motility: Experience abnormal contractions of the
muscles in the intestines, leading to changes in bowel habits such as
diarrhea, constipation, or a combination of both. The gut may be more
sensitive to distension or stretching, contributing to pain and discomfort.

9. DIAGNOSIS

10. To diagnose irritable bowel syndrome (IBS), doctors
review your symptoms and medical and family history
and perform a physical exam. In some cases, doctors
may order tests to rule out other health problems.
Review of your symptoms
Your doctor will ask about your symptoms and look for a
certain pattern in your symptoms to diagnose IBS. Your
doctor may diagnose IBS if you have pain in your
abdomen along with two or more of the following
symptoms:
• Your pain is related to your bowel movements. For
example, your pain may improve or get worse after
bowel movements.
• You notice a change in how often you have a bowel
movement.
• You notice a change in the way your stools look.

11. Blood test
A health care professional will take a blood sample from
you and send the sample to a lab. Doctors use blood
tests to check for conditions other than IBS, including
anemia, infection, and digestive diseases.
Stool test
Your doctor will give you a container for catching and
holding a stool sample. You will receive instructions on
where to send or take the kit for testing. Doctors use
stool tests to check for blood in your stool or other signs
of infections or diseases. Your doctor may also check for
blood in your stool by examining your rectum during
your physical exam.

12. SIGNS AND
SYMPSTOMS

13. • Abdominal Pain or Discomfort:
⚬ This is one of the hallmark symptoms of IBS. The pain or
discomfort may vary in intensity and is often relieved by a bowel
movement.
• Changes in Bowel Habits:
⚬ IBS can cause alterations in bowel habits, including diarrhea,
constipation, or both. Some individuals may experience
predominantly diarrhea (IBS-D), while others may have
predominantly constipation (IBS-C). In some cases, there may be
an alternation between diarrhea and constipation.
• Bloating and Gas:
⚬ Many individuals with IBS report increased bloating and gas. This
can contribute to abdominal discomfort.

14. 4. Altered Stool Consistency:
⚬ The appearance and consistency of stool may change. Some
individuals may experience loose or watery stools, while others
may have harder, pellet-like stools.
5. Urgency to Have a Bowel Movement:
⚬ Some people with IBS may feel a sense of urgency to have a
bowel movement. This urgency can be associated with diarrhea.
6. Incomplete Evacuation:
⚬ The sensation of incomplete bowel evacuation is another
common symptom. Individuals may feel the need to return to the
toilet shortly after having a bowel movement.

15. NUTRITIONAL
ASSESSMENT

16. ANTHROPOMETRIC
• Body Mass Index (BMI):
BMI is a commonly used anthropometric measurement that assesses
body weight relative to height. It provides a general indication of whether an
individual is underweight, normal weight, overweight, or obese. Changes in
BMI over time can help track changes in nutritional status.
• Waist Circumference:
Measuring the circumference of the waist can provide information about
central adiposity, which is associated with certain health risks. Changes in
waist circumference may be relevant in assessing changes in abdominal
bloating and distension, which are common symptoms in some individuals
with IBS.

17. ANTHROPOMETRIC
• Weight Changes:
Monitoring changes in body weight over time can be important,
especially if individuals with IBS experience significant weight loss
or gain. Unintentional weight loss may indicate malabsorption or
other issues that require further investigation.
• Nutritional Assessment:
Nutritional assessments may include a review of dietary habits,
nutrient intake, and the presence of nutritional deficiencies.
Individuals with IBS may experience challenges related to diet and
nutrition due to changes in bowel habits, food intolerances, or
avoidance of certain foods.

18. BIOCHEMICAL
Blood Tests:
• Complete Blood Count (CBC): To assess for anemia or signs of inflammation.
• C-reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR): Indicators of
inflammation that can help rule out inflammatory bowel diseases.
• Thyroid Function Tests: To rule out thyroid disorders, which can sometimes present
with gastrointestinal symptoms.
Stool Tests:
• Stool Culture: To rule out bacterial or parasitic infections that could be contributing to
symptoms.
• Fecal Calprotectin: Elevated levels may indicate inflammation in the intestines, which
can be a sign of inflammatory bowel diseases. It can help distinguish IBS from IBD.
• Stool Ova and Parasite (O&P) Exam: To check for the presence of parasites in the
stool.

19. BIOCHEMICAL
Glucose Testing:
⚬ Blood Glucose and Hemoglobin A1c: To rule out diabetes or impaired
glucose metabolism, which can sometimes present with gastrointestinal
symptoms.
Lactose Breath Test:
⚬ This test assesses for lactose intolerance, a condition that can cause
gastrointestinal symptoms similar to those of IBS.
Serum Electrolytes:
⚬ Repeated diarrhea in IBS-D could lead to electrolyte imbalances, and
assessing serum electrolyte levels may be relevant.
Serum Albumin:
⚬ Low levels of serum albumin could indicate malnutrition or inflammation.

20. CLINICAL
Medical History:
• A detailed medical history is crucial. Questions may focus on the onset and duration of
symptoms, changes in bowel habits, abdominal pain or discomfort, and associated factors
such as stress, diet, or specific triggers.
• Questions about diet, lifestyle, and stressors can help identify potential triggers for
symptoms.
Physical Examination:
• A physical examination may be conducted to assess for signs of abdominal tenderness,
distension, or masses. This can help rule out other potential causes of abdominal pain.
Rome Criteria:
• The Rome criteria are widely used for diagnosing functional gastrointestinal disorders,
including IBS. Meeting the criteria involves the presence of recurrent abdominal pain or
discomfort for at least six months, along with specific criteria related to changes in bowel
habits.

21. CLINICAL
Psychosocial Assessment:
• Stress and psychological factors can significantly impact IBS symptoms. Assessing the
patient's psychosocial well-being, including stress levels, anxiety, and depression, is
essential.
Educational Counseling:
• Patient education is an integral part of managing IBS. Providing information about the
condition, its chronic nature, and potential triggers can empower patients to actively
participate in their care.

22. DIETARY
Identification of Trigger Foods:
Begin by identifying specific foods that may trigger or worsen symptoms. Common triggers
include certain types of carbohydrates, fatty foods, spicy foods, caffeine, alcohol, and
artificial sweeteners.
• 24-hour Dietary Recall
• Elimination Diets:
In addition to a low-FODMAP diet, some individuals may benefit from other elimination
diets, such as gluten-free or lactose-free diets, based on specific symptoms or sensitivities.
• Nutritional Counseling:
Seeking guidance from a registered dietitian or nutritionist who specializes in
gastrointestinal disorders can be beneficial. They can provide personalized dietary advice
and help with the implementation of dietary changes.

23. ECOLOGICAL
Lifestyle Factors:
• Examine the individual's lifestyle, including work-related stress, physical
activity, and sleep patterns. Lack of physical activity, poor sleep quality,
and high levels of stress can all influence IBS symptoms.
Environmental Allergens:
• In some cases, environmental allergens, such as pollen or dust, can
exacerbate IBS symptoms. Allergies may be considered in the
assessment.
Stress and Psychological Factors:
• Explore the individual's stress levels, anxiety, and other psychological
factors. Stress and emotional well-being can have a significant impact
on IBS symptoms. Consider strategies for stress management, such as
relaxation techniques, mindfulness, or counseling.

24. NUTRITION THERAPY
• Diet Changes
• Medicine
• Stress Management
• Fiber Intake
• Small, Frequent Meal

25. TREATMENT
• DIETARY AND LIFESTYLE
MODIFICATIONS
• MEDICATIONS
• STRESS MANAGEMENT TECHNIQUES

26. THANK
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