Irritable bowel syndrome
Also called: IBS
A common long-term condition of abdominal pain with altered bowel habit — diarrhoea, constipation or both — without visible damage to the gut. Symptoms arise from disordered gut–brain signalling.
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About 1 in 10 people, more often women.
Causes
- Visceral hypersensitivity, altered gut motility and gut–brain axis dysfunction
- Often follows gastroenteritis (post-infectious IBS)
Risk factors
- Female sex
- Stress, anxiety and depression
- Previous gut infection
- Family history
Symptoms
- Abdominal pain related to bowel movements
- Bloating and distension
- Diarrhoea, constipation or alternating
- Mucus in stools
- Feeling of incomplete emptying
Diagnosis — tests and examinations
- Rome IV clinical criteria
- Basic tests to exclude other diseases: blood count, coeliac serology, faecal calprotectin
- Colonoscopy only for alarm features
Treatment
Medicines and medical treatment
- Antispasmodics (mebeverine, peppermint oil)
- Loperamide for diarrhoea
- Laxatives (ispaghula, linaclotide) for constipation
- Low-dose tricyclic antidepressant (amitriptyline) for pain
Self-care, home remedies and lifestyle
- Regular meals, adequate fluids
- Low-FODMAP diet under dietitian guidance
- Soluble fibre (ispaghula) rather than bran
- Regular exercise
- Gut-directed hypnotherapy or cognitive behavioural therapy
Possible complications
- Reduced quality of life; it does not cause cancer or damage
Prevention
- Managing stress; prompt treatment of gut infections
Outlook
Chronic but benign; symptoms fluctuate and usually improve with treatment.
When to see a doctor
See a doctor for rectal bleeding, weight loss, anaemia, symptoms starting after 50 or waking at night with diarrhoea.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
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