IBS: Irritable Bowel Syndrome
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Irritable bowel syndrome (IBS) is a common condition that affects the digestive system.
It causes symptoms like stomach cramps, bloating, diarrhea and constipation. These tend to come and go over time, and can last for days, weeks or months at a time.
Common irritable bowel syndrome (IBS) symptoms
The main symptoms of IBS are:
stomach pain or cramps – usually worse after eating and better after doing a poo
bloating – your tummy may feel uncomfortably full and swollen
diarrhea – you may have watery poo and sometimes need to poo suddenly
constipation – you may strain when pooing and feel like you cannot empty your bowels fully
farting (flatulence)
passing mucus from your bottom
tiredness and a lack of energy
feeling sick (nausea)
backache
problems peeing, like needing to pee often, sudden urges to pee, and feeling like you cannot fully empty your bladder
not always being able to control when you poo (bowel incontinence)
Management
Offer reassurance, education, and support to the patient
Fatty foods, alcohol, caffeine, spicy foods, and grains are poorly tolerated by many patients with IBS and should be avoided
Tab Mebeverine (Colofac) 135mg, 1 tab PO x TDS
Tab Hyoscamine (Anapaz) 125mcg 1tab PO x SOS for pain relief
Diarrhea predominant
Cap Loperamide (Imodium) 2mg 2caps PO Stat then one cap after each episode of loose motion.
Actiflor sachet 250mg PO BD or TDS for 1 week.
Constipation predominant
Syp Sodium Picosulfate (Laxoberon) 2 TSF PO TDS for constipation
Tab Imipramine (Tofranil) 25mg ½ tab initialy then 1 tab PO OD at night for 1 month then adjust accordingly
You can also prescribe SSRI
Tab Escitalopram (Citanew) 10mg PO OD at morning OR
Tab Fluoxetine (Depex) 20mg 1tab PO OD at morning
General tips to relieve irritable bowel syndrome (IBS) symptoms
cook homemade meals using fresh ingredients when you can
keep a diary of what you eat and any symptoms you get – try to avoid things that trigger your IBS
try to find ways to relax
get plenty of exercise
try probiotics for a month to see if they help
do not delay or skip meals
do not eat too quickly
do not eat lots of fatty, spicy or processed foods
do not eat more than 3 portions of fresh fruit a day (a portion is 80g)
do not drink more than 3 cups of tea or coffee a day
do not drink lots of alcohol or fizzy drinks