Irritable Bowel Syndrome (IBS): treatment and management

Irritable Bowel Syndrome (IBS) is a common functional disorder of the gut characterised by pain or discomfort, bloating and a change in bowel habit. IBS is a complex condition that affects sufferers on many levels. It is a therapeutic challenge to medical practitioners and other healthcare professionals. The prevalence of IBS in the UK is estimated to be between 10 and 20%, and globally, it affects between 5 and 11% of individuals. The incidence is higher in women than in men and may present at any age, although it commonly peaks between the ages of 30 and 50. Difficulties in defining and classifying IBS continue simply due to the diverse array of symptoms which presents similar difficulties in identifying the aetiology and pathophysiology of the condition.

Although a comprehensive set of guidelines to improve diagnosis, care and management of IBS in adults exists, there continues to be a number of challenges in the clinical setting. Conventional treatments range from antispasmodics/ anticholinergics to antidepressants and gut modulators. Other second line treatment strategies include non-drug therapies such as cognitive behavioural therapy (CBT) and hypnotherapy which shows great promise. Lifestyle modifications and strategies include exercise and stress-management techniques.

A strong emphasis on dietary management highlights a number of triggers of dietary origin and the approach is very much centred on examining this on a case by case basis. Herbal approaches have proved enormously beneficial not only on a symptomatic level but on a holistic level too as this considers the patient, their diet, their lifestyle, their personality and the context of their symptoms. The different management strategies that patients have adopted not only reveal how diverse IBS is but how effective and unique each strategy is to individual patient profiles. The strategies help patients cope with their symptoms and enables them to take steps to limit acute episodes or abate the worst effects of this chronic and often unpleasant condition.

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Primary Health Care 2009; 19(8): 26-34rcnpublishing

Primary Health Care Journal is a Royal College of Nursing (RCN) Publication