oa SA Pharmaceutical Journal - Irritable bowel syndrome : evidence-based pharmacy practice



Irritable bowel syndrome (IBS), or spastic colon, is a syndrome with numerous symptoms, and is associated with abdominal colicky pain and disturbed gastrointestinal functioning (constipation or diarrhoea, or a fluctuation between both) in the absence of organic disease. Previously it was considered to be a diagnosis of exclusion. There is no single confirmatory test and no specific cure for IBS. Several diagnostic criteria exist that evaluate symptoms and their duration, for example, the Manning and Rome criteria, but they are not always helpful in practice because of complex interactions between IBS and chronic pain syndromes. The condition is extremely common, especially in young adults, but symptoms can occur at any age. Emotion and stress are aggravating factors. Lifetime prevalence is estimated to be approximately 20%, but most patients never consult a medical practitioner. Treatment should be tailored to individual symptoms with dietary changes, exercise, psychotherapy and medication (e.g. bulk-forming laxatives, antispasmodics, antibiotics, probiotics and/or agents active at serotonin receptors). The pharmacist has an important supportive role to play in the optimal management of IBS.


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