Irritable Bowel Syndrome

Symptoms:

  • Stomach cramps
  • Bloating
  • Diarrhoea and constipation
Prevalence
  • Women
  • First cases are often reported from the age of 30 to 50 years.
  • Stress or diet can trigger attacks.
Red Flags
  • Rectal bleeding associated with a change in bowel habit should be referred to GP. This will allow investigation to exclude GI carcinoma and inflammatory bowel diseases that are associated with a change
    in bowel habit.
  • If the rectal bleeding is severe or associated with any systemic symptoms then urgent referral is needed.
  • Rectal bleeding from haemorrhoids does not need to be referred.

 

Pharmacological Treatments

Bulk-forming laxatives are used when constipation is the dominant symptom.

Anti- diarrhoeal drugs, e.g. loperamide are used where diarrhoea is the predominant symptom.

Anti-spasmodic agents, e.g. mebeverine, alverine citrate are used for abdominal pain.



The smooth muscle relaxant properties of the antimuscarinics may be useful such as; Hyoscine butylbromide (this is poorly absorbed which may limit its effectiveness).

Peppermint oil is believed to have direct relaxant properties of intestinal smooth muscle. It is not recommended in children.