irritable%20bowel%20syndrome
IRRITABLE BOWEL SYNDROME
Irritable bowel syndrome is a common chronic gastrointestinal condition characterized by abdominal pain and bloating with altered bowel habits.
There are no identifiable physical, radiologic or lab abnormalities indicative of organic disease.
Symptoms may be exacerbated by stress, alcohol or food.

Lifestyle Modification

Dietary Monitoring
  • It may be helpful to have patients keep a diary of food intake, symptoms including severity and possible exacerbating factors (eg emotional issues) for 2-3 weeks
  • Physician may then be able to make lifestyle or diet modification suggestions based on the above
Recommended dietary modifications for IBS patients (British Dietetic Association):
  • If IBS is complicated by fructose malabsorption, reduce all short-chain carbohydrates from diet (ie fructose, polyols)
  • A 4-week trial with Probiotics may be considered after fructose malabsorption has been ruled out
  • If lactose intolerance is suspected, a trial period of low-lactose diet may be advised; if confirmed via a positive lactose hydrogen breath test, low lactose diet is highly recommended
  • Wheat/corn bran supplementation may be used only within the usual daily intake
  • Elimination/empirical diet is recommended for 2-4 weeks when specific foods are suspected of causing IBS symptoms; if no improvement after 4 weeks, consider other factors or refer to specialist
  • Other general dietary modifications include drinking at least 2000 mL of fluid daily, reducing intake of alcohol, caffeinated drinks or softdrinks, restricting fresh fruit intake to 3 portions daily, avoiding sorbitol if patient has diarrhea
IBS with Constipation
  • A 3-month trial with ground linseeds is recommended for IBS-C patients with abdominal pain and bloating
  • May suggest to patient to increase dietary intake of fiber gradually to 20-25 g/day over a few weeks
  • Dietary fiber assists with constipation but does not seem to improve abdominal pain
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Erica Makin, MBChB, MSc, FRCS (Paeds); Mark Davenport, ChM, FRCS (Eng), FRCS (Paeds), 01 Apr 2013

There is a multiplicity of causes of acute abdominal pain during childhood although for the purposes of this article those presenting predominantly during the neonatal period will be excluded. Although common sense tells us that most children with acute abdominal pain will have self-limiting conditions, it is important to identify those where there is a more serious surgical or medical emergency. The history of the complaint is the beginning of the diagnostic process and certain conditions are much more common in a particular age group, eg, intussusception. Still, accurate diagnosis can be challenging in the young non-verbal child or those with learning difficulties.