This document discusses irritable bowel syndrome (IBS). IBS is a common disorder affecting the large intestine that causes abdominal pain, bloating, constipation, and diarrhea. While the exact causes are unknown, factors like psychological issues, altered gut motility, abnormal pain perception, and past gastrointestinal infections may play a role. IBS symptoms can range from mild to severe and most commonly begin in late teens or early adulthood. Diagnosis involves ruling out other conditions through tests and meeting symptom-based diagnostic criteria. Treatment focuses on relieving symptoms through diet, medication, psychological support, and in some cases antibiotics or probiotics.

1. IRRITABLE BOWEL SYNDROME(IBS)
SWATILEKHA DAS
(RN,MSN)

2. INTRODUCTION
IBS is a common disorder that affects
the large intestine(colon).

3. DEFINITION
IBS is a disorder characterized by
cramping, abdominal pain, bloating,
constipation and diarrhoea.
Young women(˂ 40 years) are commonly
affected.

4. ETIOLOGY
Exact causes are not known.
• Psychological factors-anxiety, depression
• Altered GI motility
• Altered visceral sensation- Abdominal pain in IBS
patients can be reproduced by balloon distension of
rectum, colon or small intestine at volumes which do
not cause pain in control subjects, indicate abnormal
perception of visceral sensation.
• Luminal infection- about 10-20% patients develop
symptoms of IBS following gastroenteritis.

5. CLINICAL MANIFESTATIONS
Symptoms may range from mild to severe. IBS can start at any
age, but are most common in late teenage years or early.
 Abdominal fullness
 Loss of mucus from the rectum
 Urgency to pass stools
 Abdominal pain
 Sense of incomplete evacuation
 Gas & bloating
 Constipation
 Diarrhoea
 Difficulty passing stool
 Passing mucous in stools

6. DIAGNOSTIC TESTS
 Complete history taking and physical
examination
 Barium enema
 Ultrasound
 Stool examination
 Upper GI study
 Colonoscopy/Sigmoidoscopy

7. ROME SYMPTOM DIAGNOSTIC
CRITERIA IS DEPICTED BELOW-
A. At least 3 months of continuous or
recurrent abdominal pain that is:
Relived with defecation, and/or,
Associated with change in frequency of stool,
and/or,
Associated with a change in consistency of
stool

8. B. Two or more of the followings at least
on one –fourth of occasions or days:
Altered stool frequency(˃3 bowel
movements daily or ˂ 3 bowel movements
weekly)
Altered stool consistency (lumpy/hard or
loose/watery stools)
Altered stool passage (straining, urgency or
feelings of incomplete evacuation)
Passage of mucus
Abdominal bloating or distension

9. MANAGEMENT
The goal of the treatment is to relieve
symptoms-
 Reassurance and psychological support
 Dietary advice- patients should avoid dairy
products, foods, beverages, or medications
containing fructose or sorbital, excessive
caffeine or gas forming foods such as brown
beans, brussels, cabbage, cauliflower,onions.
High fibre diets such as ISPAGULA HUSK
preparations are most effective in patients with
constipation. High fibre foods are needed to
relieve constipation.

10. Patients with diarrhoea may benefit
from a morning dose, if necessary,
two or three daily doses of an
antidiarrheal agent i.e. Loperamide
or Codeine Phosphate.
Antispasmodic is commonly
prescribed, which helps to control
colon muscle spasms & reduce
abdominal pain i.e. Spasmonal,
Colofac, Buscopan & Peppermint
Oil.

11. Administering Anticholinergic
medications (Dicyclomine,
Propantheline) about a half hour
before eating to control colon
muscle spasms.
Antidepressants may relieve some
symptoms.
Controlled clinical trials have
shown benefit with non-absorbable
Antibiotics (Rifixamin 400mg, TDS)
& Probiotics.