Management of patients with irritable bowel syndrome

Irritable bowel syndrome is a common condition in primary care and accounts for more than 30% of hospital gastroenterological outpatient consultations. It is characterised by abdominal pain and accompanied by altered bowel habit and often extra-intestinal symptoms such as tiredness and urinary frequency. A positive diagnosis can be made with confidence given the typical history and the absence of 'alarm features', supported by a small number of appropriate investigations. Managing patients with irritable bowel syndrome can be challenging but should be based on an empathic appreciation of the psychosocial context of their symptoms. Pharmacological treatment should be symptom-based and may include dietary manipulation, antidiarrhoeals, laxatives, tricyclic antidepressants and selective serotonin reuptake inhibitors.