Treatment of irritable bowel syndrome

Abstract

Irritable bowel syndrome is a chronic functional gastrointestinal disorder that presents with abdominal pain, related to defecation, accompanied by a change in stool frequency or form. Despite its impact on a patient’s quality of life, it has no effect on mortality. A positive clinical diagnosis should be made if the characteristic symptoms are present and red flags are absent. Red flags should prompt specialist referral. Consultations should be provided in an empathetic manner, addressing the concerns of the patient while providing reassurance. Manipulating diet, with the assistance of a dietitian, is an appropriate initial treatment for irritable bowel syndrome. A low-FODMAP diet is an effective therapy. Low-dose antidepressants improve symptoms but can be accompanied by adverse effects. Antispasmodic drugs have a limited role. Psychological therapies and gut-focused hypnotherapy are effective if patients are willing to try them.