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Irritable bowel syndrome.

Robin C Spiller1

  • 1Wolfson Digestive Diseases Centre, University Hospital, Nottingham, NG7 2UH, UK. robin.spiller@nottingham.ac.uk

British Medical Bulletin
|March 16, 2005
PubMed
Summary
This summary is machine-generated.

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder affecting millions globally. Diagnosis relies on Rome criteria, with treatments ranging from dietary changes to medications and psychotherapy.

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Area of Science:

  • Gastroenterology
  • Psychosomatic Medicine

Background:

  • Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder, frequently encountered in primary care settings.
  • It disproportionately affects women and is characterized by chronic abdominal pain, altered bowel habits, and visceral hypersensitivity.

Purpose of the Study:

  • To provide a comprehensive overview of Irritable Bowel Syndrome (IBS), including its epidemiology, diagnostic criteria, and management strategies.
  • To highlight the differential diagnosis of IBS and the role of psychological factors.

Main Methods:

  • Literature review of IBS epidemiology, pathophysiology, diagnosis, and treatment.
  • Discussion of diagnostic criteria (Rome criteria) and exclusion of organic diseases.
  • Exploration of therapeutic approaches including dietary modifications, pharmacotherapy, and psychotherapy.

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Main Results:

  • IBS affects a significant portion of the population worldwide, with similar prevalence in Western and developing countries.
  • Post-infectious IBS can develop in 5-10% of patients after bacterial gastroenteritis.
  • Differential diagnoses include microscopic colitis, bile salt malabsorption, and infections, though uncommon in Western societies.

Conclusions:

  • Reliable diagnosis of IBS is achievable using Rome criteria, provided 'alarm' features are absent.
  • Treatment is tailored to symptom presentation, including exclusion diets, medications (loperamide, 5HT3 antagonists, 5HT4 agonists, antispasmodics, antidepressants), and psychotherapy.
  • Early diagnosis and appropriate management are crucial, as new diagnoses are rare once criteria are met.