Irritable bowel syndrome

• What sex is IBS more common in?

  Males
• What are some factors for developing IBS?

  Altered GI motility

  Visceral hypersensitivity

  Dysbiosis

  Genetics

  Environment
• What system is used to classify IBS?

  Rome IV criteria
• What are the different Rome IV criteria?

  IBS-C

  IBS-D

  IBS-M

  IBS-U
• What is IBS-C?

  IBS with predominant constipation
• What is IBS-D?

  IBS with predominant diarrhoea
• What is IBS-M?

  IBS with mixed constipation and diarrhoea
• What is IBS-U?

  IBS unclassified
• When should a diagnosis of IBS be considered?

  Experienced the following for 6+ months:

  • Abdo pain
  • Bloating
  • Change in bowel habit
• When should a +ve diagnosis of IBS be made using the Rome IV criteria?

  Recurrent abdo pain for at least 1 day a week for 3 months + 2 of the following:

  • Pain related to defecation (either relieved or worsened)
  • Change in stool frequency
  • Change in appearance of stool
• What are some red flag features to look out for?

  Rectal bleeding

  Unintentional weight loss

  Family history of bowel or ovarian cancer

  60+ years old
• What are some suggested primary care investigations for IBS?

  FBC

  ESR/CRP

  Coeliac disease screen
• What is the first line pharm treatment for IBS?

  Pain: Antispasmodic agent

  Constipation: Laxatives (avoid lactulose)

  Diarrhoea: Loperamide