Irritable Bowel Syndrome (IBS) - Diagnosis and Management Summary
• Definition (per Rome IV Criteria): recurrent abd discomfort ≥ 1x/wk on average for 3 months a/w 2+ of the following:
(1) related to defecation
(2) change in stool frequency
(3) change in stool form. No nocturnal pain, weight loss, bleeding, elevated ESR/CRP.
• Epidemiology: ↑ risk w/ younger age, ♀ > ♂, psychosocial stressors, low QoL, hypochondriasis; bacterial gastroenteritis may be trigger.
• Types: IBS-C (constipation-predominant), IBS-D (diarrhea-predominant), IBS-M (mixed), IBS-U (unclassified), by Bristol Stool Score
• Treatment: exercise, diet modification, cognitive-behavioral therapy; laxatives (lubiprostone, linaclotide, PEG) for IBS-C; rifaximin, luxadoline,loperamide for IBS-D (limited data)
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