The Singapore Family Physician

Back to issue Vol 35 No. 1 - Gastrointestinal diseases

Diagnosis & Management of the irritable bowel syndrome

Gwee Kok Ann
The Singapore Family Physician Vol 35 No 1 - Gastrointestinal diseases
35 - 40
1 March 2009
0377-5305
The irritable bowel syndrome (IBS) is a condition characterised by abdominal pain, bloating or other discomfort occurring in association with disturbed bowel movement in the absence of major structural or organic cause that can be detected by routine medical tests. What is the best way to identify IBS patients? The first widely recognized set of criteria was the Manning Criteria. Since 1994 the Rome Criteria has been developed largely by US and European researchers. Presently the Rome criteria are employed primarily for research. ANMA has now developed a set of expert consensus statements providing recommendations on a clinical approach to the diagnosis of IBS. At the primary care level, use of a screening algorithm comprising symptom criteria, a checklist of alarm features and guidelines on monitoring procedure, is recommended. The aims of IBS treatment are symptom relief and improvement in quality of life. A good doctor-patient relationship is important in the management of IBS. Physicians should try to identify the contributing factors and address the patient’s concerns. Management of IBS should be individualized and target all bothersome symptoms, IBS subtypes, severity of symptoms and contributing factors including psycho-social issues.