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Feature Article

Irritable bowel syndrome: how to help your patients

Allison Malcolm, John E Kellow

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Abstract

Irritable bowel syndrome can be difficult to manage. Identification of precipitating or contributing factors is important, and a trial of medication may be warranted in patients who have ongoing problems.

Key Points

  • Irritable bowel syndrome (IBS) is the most common disorder of the digestive tract. It often leads to considerable healthcare use, decreased quality of life and increased absenteeism from work.
  • Visualisation of the entire colon should be performed in patients presenting for the first time with symptoms of suspected IBS after the age of 40 or 50 years.
  • ‘Postinfective irritable bowel syndrome’ is a well recognised entity. Symptoms may persist for months or even years.
  • Medications are important causes of constipation and diarrhoea.
  • The treatment of IBS is based on the specific pattern of symptoms, particularly the predominant symptom.
  • When starting treatment with fibre supplements, start with a low amount and increase slowly to avoid side effects.

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