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Irritable bowel syndrome - Making a diagnosis
How do I know my patient has it?
- Consider irritable bowel syndrome (IBS) in a person who has had any of the following symptoms for at least 6 months:
- Abdominal pain or discomfort, or
- Bloating, or
- Change in bowel habit.
- Diagnose IBS if:
- The person complains of abdominal discomfort or pain which is either:
- Relieved by defecation, or
- Associated with altered bowel frequency (increased or decreased) or altered stool form (hard, lumpy, loose, watery).
- And the person has at least two of the following symptoms:
- Altered stool passage (straining, urgency, incomplete evacuation).
- Abdominal bloating (more common in women than men), distension, tension, or hardness.
- Symptoms made worse by eating.
- Passage of mucus.
- And other conditions with similar features have been ruled out — see Differential diagnosis.
- The diagnosis is supported if the person also has lethargy, nausea, backache, headache, bladder symptoms, dyspareunia, or faecal incontinence (this information will often not be volunteered).
- There is no investigation to confirm a diagnosis of IBS.
[Spiller, 2007; National Collaborating Centre for Nursing and Supportive Care, 2008]
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