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

• Post-infectious irritable bowel syndrome
• See abdominal pain

Management

• Consider prescribing ondansetron up to 24 mg/d for IBS-D
• 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

External Links

Patient Information

Irritable Bowel Syndrome (National Digestive Diseases Information Clearinghouse)