Diagnosis and Treatment of IBS By : Wasfi Rababa’h Supervised by : Dr. Mohammad Al-Ani

Diagnosis of IBS First of all we should mention that there's no test to definitively diagnose IBS. People are most likely to get the condition in their late teens to early 40s. So we should start with a complete medical history, physical exam and tests to rule out other conditions. After other conditions have been ruled out, your doctor is likely to use one of these sets of diagnostic criteria for IBS:

Diagnosis of IBS ( Conti. ) Rome criteria: These criteria include abdominal pain and discomfort lasting on average at least one day a week in the last three months. This should be accompanied by at least two of the following four symptoms:

Diagnosis of IBS ( Conti. ) 1- a change in how you pass stools – such as needing to strain, feeling a sense of urgency or feeling you have not emptied your bowels properly. 2- bloating, hardness or tension in your stomach. 3- your symptoms get worse after eating. 4- passing mucus from your back passage.

Diagnosis of IBS ( Conti. ) Manning criteria:  These criteria focus on pain relieved by passing stool and on having incomplete bowel movements, mucus in the stool and changes in stool consistency. The more symptoms you have, the greater the likelihood of IBS.

Diagnosis of IBS ( Conti. ) Type of IBS: For the purpose of treatment, IBS can be divided into three types, based on your symptoms: 1- constipation-predominant This comes with stomach pain  and discomfort, bloating , abnormally delayed or infrequent bowel movement , or lumpy/hard stool.

2- diarrhea-predominant: This comes with stomach pain and discomfort, an urgent need to move your bowels, abnormally frequent bowel movement , or loose/watery stool. 3- mixed. There are about an equal number of people with IBS in each category. There is also evidence that most people with IBS will alternate between types over time.

Treatment Treatment of IBS focuses on relieving symptoms so that you can live as normally as possible. Mild signs and symptoms can often be controlled by managing stress and by making changes in your diet and lifestyle. For example you can try the following :

Treatment ( Conti. ) 1- Avoid foods that trigger your symptoms 2- Eat high-fiber foods 3- Drink plenty of fluids 4- Exercise regularly 5- Get enough sleep

Your doctor might suggest that you eliminate from your diet: High-gas foods. If you experience bloating or gas, you might avoid items such as carbonated and alcoholic beverages, caffeine, raw fruit, and certain vegetables, such as cabbage, broccoli and cauliflower.

Gluten. Research shows that some people with IBS report improvement in diarrhea symptoms if they stop eating gluten (wheat and barley) even if they don't have celiac disease.

FODMAPs. Some people are sensitive to certain carbohydrates such as fructose, fructans, lactose and others, known as FODMAPs — fermentable oligo-, di-, and monosaccharides and polyols. FODMAPs are found in certain grains, vegetables, fruits and dairy products. Your IBS symptoms might ease if you follow a strict low-FODMAP diet and then reintroduce foods one at a time.

Thank you References : www.webmd.com www.mayoclinic.org