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Feature Article

Managing irritable bowel syndrome

Reme Mountifield, Jane M Andrews

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Abstract

Irritable bowel syndrome is a functional disorder of the bowel affecting nearly 17% of adults in Australia and accounting for 25 to 50% of all referrals to gastroenterologists. Successful management encompasses an appreciation of its multifactorial aetiology and a biopsychosocial approach to treatment.

Key Points

  • IBS is a common, lifelong functional gastrointestinal disorder in which the hallmarks are abdominal pain associated with changes in bowel habit (stool form and/or frequency).
  • A positive diagnosis of IBS is made clinically by identifying the typical symptom complex.
  • A diagnosis of IBS requires at least six months of symptoms, with the patient having had three days of symptoms monthly for the past three months.
  • Organic pathology can usually be simply excluded by the recognition of alarm features.
  • Of those patients with IBS, 50% have coexistent depression/anxiety symptoms that should be sought and addressed.
  • Management of IBS should be biopsychosocial and individualised, with options ranging from reassurance, education, dietary modifications and psychological interventions to a variety of medications aimed at controlling exacerbating symptoms.

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