Irritable bowel syndrome

Background
  1. psychosocial factors
  2. altered gut motility
  3. hypersensitive intestinal pain perception

Evaluation

Criteria
  1. Three months of abdominal pain:
    1. relieved by defecation
    2. associated with change of stool freq
    3. related to a change in stool consistency
  2. AND, 2 or more of the following symptoms 25% of the time
    1. >3 bm per day or < 3 bm per week
    2. altered stool form
    3. altered stool passage
    4. passage of mucous
    5. bloating

Workup
  • Diagnosis of exclusion

Differential Diagnosis

Management
  • Consider prescribing ondansetron up to 24 mg/d for IBS-D[1]
  • Typical bowel regimen treatments for IBS-C
    • May consider low-dose TCA if appropriate follow up with PCP will occur

See Also
  • Abdominal Pain
  • Postinfectious irritable bowel syndrome

Patient Information

Irritable Bowel Syndrome (National Digestive Diseases Information Clearinghouse)

References
  1. Garsed K, Chernova J, Hastings M, et al. A randomised trial of ondansetron for the treatment of irritable bowel syndrome with diarrhoea. Gut. 2014;63:1617-1625.
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