Irritable Bowel Syndrome
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Expert Reviewer
Dr John Wyeth, Gastroenterologist and Clinical Director of Medicine, Capital & Coast DHB
Key Points
- The diagnosis of IBS can be made from the clinical history as long as there are no alarm features of other pathology
- In primary care, the mainstays of treatment are explanation and reassurance, coupled with sensible advice about lifestyle, diet and stress
- Treatment is tailored to the predominant symptoms
- People with IBS often report a close relationship between stress and their bowel symptoms and both anxiety and depression are common in people with IBS
- Psychological support is an integral part of the management of IBS in primary care and there is some evidence more formal psychological therapies can be effective
- The results of pharmaceutical interventions for IBS are often disappointing but some individuals will get good responses
Background
Irritable Bowel Syndrome (IBS) affects approximately one in ten of the population, mostly women between the ages of 20 and 50 years.
The diagnosis of IBS can be made from the clinical history as long as there are no alarm features of other pathology. However a firm diagnosis cannot be made until symptoms have been present for the previous three months with onset of symptoms at least six months before diagnosis. IBS has a prolonged course and over half of people with it still get symptoms seven years after diagnosis.
Although symptoms may occur over a long period of time, with no risk of life threatening complications, making a diagnosis as early as possible is useful. It helps prevent exacerbation of the anxiety many people with IBS experience and prevents additional costs and risks from unnecessary investigations.
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