Irritable bowel

syndrome (IBS)

Group (4)
 Objectives

01 Define irritable bowel

syndrome
List the causes of irritable
bowel syndrome 02

List the diagnostic criteria

03 (Room) Describe in brief the
clinical picture 04

05 Describe
investigations
Describe complications
06
Describe treatment of irritable
07 bowel syndrome
01 Definition
 What is IBS ?

Irritable bowel syndrome is a functional or

symptom-based GI disorder
characterized by chronic and/or recurrent
abdominal pain or discomfort and altered
bowel habits in the absence of organic
cause.
02 Causes of IBS
What are the causes of IBS ?
Factors that appear to play role include:

1- Muscle contractions in the intestine.

2- Life stress: people exposed to stressful

events tend to have more symptoms of IBS.

3- Severe infection.

4- Change in gut microbes.

-Triggers: Symptoms of IBS can be

triggered by:
 03

Diagnostic criteria of IBS

Rome criteria
 Rome IV criteria

Recurrent abdominal pain on average at least 1 day/week

in the last 3 months, associated with two or more of the
following criteria:
Associated with a change Associated with a change
in the frequency of stool in the form (appearance)
of stool
Related to
defecation

These criteria should be fulfilled for the last 3 months with symptom onset
at least 6 months prior to diagnosis .
 Four bowel patterns may be seen with irritable bowel syndrome,
and these remain in the Rome IV classification.

These patterns include the following:

• IBS-D (diarrhea predominant).
• IBS-C (constipation predominant).
• IBS-M (mixed diarrhea and constipation). IBS-U (unclassified; the symptoms
cannot be categorized into one of the above three subtypes).
The Rome IV criteria differ from the Rome III criteria in basing bowel habit
on stool forms solely during days with abnormal bowel movements rather
than on the total number of bowel movements.
04
Clinical picture
Paitent presented with:
When to see a doctor ?
See your doctor if you have a persistent change in bowel habits or IBS
More serious signs and symptoms :

1. Weight loss
2. Diarrhea at night
3. Rectal bleeding
4. Iron deficiency anemia
5. Unexplained vomiting
6. Difficulty swallowing
7. Persistent pain that isn't relieved by
passing
8. gas or a bowel movement

12
 Red flag that call for special attention:

▪ New symptom onset at age of 50 or older.

▪ Blood in the stools (red blood or black, tarry stool).

▪ Fever, shaking chills, or night sweats.

▪ Nighttime symptoms that wake you up.

▪ Unintentional weight loss.

▪ Change in your typical IBS symptoms (like new and different pain).

▪ Family history of other GI diseases, like cancer, inflammatory bowel disease, or

celiac disease.
 05
Investigations
 Investigations

Irritable bowel syndrome is clinically diagnosed , but we may do

some labs test to rule out other etiologies:
1- CBC with differntial
2- ESR , CRP
3- celiac disease serolgy
4- Fecal calprotectin
5- Stool examination
6- Thyroid Function test

7—*Colonscopy* It’s only recommended in high risk patient

 06

complications
 physical Complications

01 Diarrhea and constipation Vitamins and minerals 04

deficiencies

02 Hemorrhoids Weight loss 05

03 Intolerance to certain
foods
 Complications
psychosocial

01 Poor quality of life depression

04

05 Anxiety
02 Interference in professional life

03 Interference in personal
relationship
 07

Treatment
Non-pharmacological treatment

• Dietary adjustments
Soluble fiber supplements
Avoidance of trigger foods
Consider support of a registered dietician.
• Lifestyle changes
Regular physical activity
Stress management and relaxation techniques)
• Adjunctive therapy
such as peppermint oil and probiotics
 Pharmacological treatment

• For Diarrhea
Loperamide
Rifaximin
• For Constipation
Osmotic laxatives as Polyethylene glycol (PEG)
• For Abdominal pain
Antispasmodics: e.g., dicyclomine, hyoscyamine

Clinical pic
1. Abdominal cramping
2. Bloating feeling
3. Diarrhea & constipation
4. Gas
5. Acid reflux & nausea
6. Mucus in the stool
Summary
Definition
functional or symptom-based GI disorder with
chronic and/or recurrent abdominal pain or
discomfort and altered bowel habits in the
absence of organic cause.
Treatment
Nonpharmacological treatment includes
dietary modifications (e.g., avoidance of
trigger foods) and psych behavioral
therapies. Pharmacological therapies such
as loperamide, laxatives

Causes
IBS could be caused by inflammation , Rome critiria
bacterial , consumption of specific Symptoms of disordered
food and changes in intestinal and bowel habits start 6 months
colonic microflora prior to diagnosis and
present during last 3 months
Investigations
IBS is clinically diagnosed but we may Complications
order: CBC , ESR , CRP , serology, The effect on a person's quality of life
stool analysis is the biggest complication of IBS.
1- Lacy BE, Patel NK. Rome Criteria and a
Diagnostic Approach to Irritable Bowel Syndrome. J
Clin Med. 2017 Oct 26;6(11):99. doi: References
10.3390/jcm6110099. PMID: 29072609; PMCID:
PMC5704116.
2- Ambouss
3-https://emedicine.medscape.com/article/180389-
overview
 • Somayah almadani…
43908095
Presented by: • Ghaida alzhrani…
43910075
• Layal alfaqih…
43900122
• Rana Alghamdi…
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• Hanin Alosaimi…
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• Atheer Althagafi…
43901821
• Raghad Altwairqi…
43900244
• Rodina Saleh…
43903990
• Bayan Altowairqi...
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• Renad Alshaer…
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• Shahad Alrdadi…
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• Marah Alqorashi...
43903124
Thank you
Any quastions ?