GI Disturbance:

Irritable Bowel Syndrome

Maniego, Marie Angelique
Bestavilla, Jerson I.
Sumampong, Mariel
Ligsay, Kezia
 Irritable bowel syndrome (IBS) is a
chronic functional disorder that affects
frequency of defecation and
consistency of stool. It’s one of the
most common GI conditions.
Sometimes called spastic colon, it
occurs more commonly in women
than in men.
People with IBS often:
Feel very self-conscious
Have low self-confidence
Try to hide their condition from those around
them
IBS can stop individuals from:
Going to work
Socializing
Eating the foods they enjoy
 Causes/ Risk factors

 To the medical community, IBS is a “functional” disorder in which “the

primary abnormality is an altered physiological function rather than an
identifiable structural or biochemical cause,” according to the
International Foundation of Functional Gastrointestinal Disorders.
 Translation: while medical researchers have yet to pinpoint an exact
cause of IBS, they are confident that symptoms are produced by
abnormal function of the nerves and muscles of the bowels. Something
in the interaction between the gut, the brain, and the overly sensitive.
Stress can be deadly.
 Although no specific structural or biochemical alterations have been
found, various factors are associated with the syndrome: heredity,
psychological stress or conditions like depression and anxiety, large
meals, a diet high in fat and irritating foods, alcohol consumption, and
smoking.
 Pathophysiology

IBS results from a functional disorder of intestinal

motility. The change in motility may be related to
neuroendocrine dysregulation, especially changes in
serotonin signaling, infection, irritation, or a vascular or
metabolic disturbance. The peristalsic waves are
affected at specific segments of the intestine and in
the intensity with which they propel the fecal matter
forward. There is no evidence of inflammation or tissue
hanges in the intestinal mucosa.
Signs & symptoms
 Symptoms vary widely, ranging in intensity and duration form mild and infrequent to sever and
continuous. The main symptom is an alteration in bowel patterns: constipation (IBS-C 34%), diarrhea
(IBS-D 27%) or combination of both (IBS-A 39%). There is pain, bloating and abdominal distention
accompanied. Abdominal pain is often described as either nagging and sharp, or heavy and dull. It is
sometimes precipitated by eating and is frequently relieved by defecation. The person also
experiences sensation of incomplete emptying after defecation.
 Diagnosing IBS
 IBS is diagnosed by its symptoms, not be particular medical test. That’s
because bowel is a normal, healthy bowel, both to the naked eye and
under the microscope. For some reason, though, IBS does not coordinate its
functions normally. It is also extra-sensitive to food, stress, and other
stimulations. However, IBS does not lead to bowel cancer or other serious
bowel diseases such as colitis, Crohn’s disease, or ulcers.
 Doctors look for a specific patternof wymptoms when diagnosing IBS. If the
client have experienced at least three common symptoms for more than
three months, then the individual meet the criteria for a diagnosis of IBS. The
more symptoms the client experience, the more likely he/ she is having IBS.
 Symptoms not related to IBS

Blood in the stool/ bleeding

Unexplained weight loss
Fever
 Medical management
 The goals of treatment are controlling diarrhea or constipation,
relieving abdominal pain and reducing stress.
Restriction and then gradual reintroduction of foods that are
possibly irritating may help determine food irritants (e.g. b
High-fiber diet is prescribed to help control diarrhea and
constipation.
Exercise can increase intestinal motility.
Hydrophilic colloids and antidiarrheal agents may be given to
control diarrhea and fecal urgency.
Antidepressants treat underlying anxiety but also have
secondary benefits like affecting serotonin levels, thus slowing
intestinal transit time and improving diarrhea and abdominal
comfort.
Anticholinergic or antispasmodic agents may be
prescribed to decrease smooth muscle spasm, decreasing
cramping and constipation.
Lubiprostone, a chloride channel regulator in the gut, is
now being used for treating persons with IBS-C.
Alosetron has been approved to treat IBS-D.
Probiotics contain bacteria like Lactobacillus and
Bifidobacterium that help decrease abdominal bloating
and gas.
Complementary medicines include artichoke leaf extract,
peppermint oil, and caraway oil reputedly diminish IBS
symptoms; however, formal studies are needed to
examine their effectiveness.
 Nursing Diagnosis
Pain
Imbalance Nutrition: Less than body
requirements
Bowel incontinence related to increased
peristaltic movement
Anxiety
 Nursing management
Provide patient and family education.
Emphasize good dietary habits like avoidance of food
triggers, eat meals regularly and chew food slowly and
thoroughly.
Avoid drinking water during meals because this results in
abdominal distention.
Discourage drinking of alcohol and smoking.
Encourage relaxation techniques like yoga and cognitive-
behavioral therapy for stress management.
Lastly, instruct client to do food diary to identify problem
foods.
 Reference
 Hinkle, J., & Cheever, K. (2014). Medical-Surgical Nursing. 13th ed.
839 EDSA South Triangle, Quezon city, Philippines. Lippincott Williams
& Wilkins. Pages 1292-1293.
 Rubin, J.,& Brasco, J. (2006). The Great Physician Rx for Irritable
Bowel Syndrome. 1st ed. Nashville, Tennessee. Thomas Nelson Inc.
Page 7.
 Burstall, D., Vallis, M., & Turnbull, G. (2006). IBS Relief: A Complete
Approach to Managing Irritable Bowel Syndrome. 2nd ed. Hoboken,
New Jersey. John Wiley & Sons Inc. Pages 5-7.
 Bull, E., & Stevens, R. (2006). Simple Guides: Irritable Bowel Syndrome.
1st ed. 1 Bankside, Lodge Road, Long Hanborough Oxfordshire,
OX29 8LI, UK. CSF Medical Communications Ltd. Pages 12-22.