Definition
Functional disorder of the gastrointestinal tract characterized by chronic abdominal pain and altered bowel habit
Chronic disorder of brain-gut interaction characterized by chronic abdominal pain and altered bowel habits in the absence of an organic disease
ROME IV criteria
Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria:
- Related to defecation
- Associated with a change in frequency of stool
- Associated with a change in form (appearance) of stool
Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis
There are four subclasses.
Patients should be advised that no more than 2% of patients need their diagnosis of IBS to be revised at 30 years of follow-up.
Faecalcalprotectin is emerging as a possible can-didate to differentiate IBS from an organic cause of diarrhoea
Approximately 5% of patients fulfilling IBS diag-nostic criteria will have histological evidence of coeliac disease compared to 0.5% of controls without IBS symptoms.
Treatment
Diet: FODMAP
In IBS-D reduction in caffeine and sorbitol (found in chewing gum and sweeteners) can help
Pharmacological IBS-D: Loperamide