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ROME III CRITERIA

*

(LONGSTRETH ETAL 2006)

Recurrent abdominal pain or discomfort

**

at least 3 days per month

in the last 3 months associated with 2 or more of the following:

1. Improvement with defecation

2. Onset associated with a change in frequency of stool

3. Onset associated with a change in form (appearance) of stool

*

Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.

**

Discomfort means an uncomfortable sensation not described as pain. In pathophysiology

research and clinical trials, a pain/discomfort frequency of at least 2 days a week during screening

evaluation for subject eligibility.

Irritable Bowel Syndrome

FOURTEEN

Irritable Bowel Syndrome

The aetiology of IBS is not yet fully

understood; however, diet, lifestyle

and psychological factors are currently

deemed to have a contributing role

towards symptoms. Interestingly, up to

two thirds of IBS patients believe that

their diet influences their symptoms of IBS.

An IBS diagnosis results from the

exclusion of other potential conditions

or diseases such as Coeliac Disease and

Inflammatory Bowel Disease (IBD). Figure

1 demonstrates the ROME III criteria,

which is often used to explain to patients

how their set of symptoms fits in with an

IBS diagnosis.This is after ‘red flags’ (see

NICE 2008 Irritable Bowel Syndrome

in adults: Diagnosis and management of

Irritable Bowel Syndrome in primary care)

are investigated and other more serious

types of diagnosis have been ruled out.

(Refer to Figure 1 below).

The symptom profile of IBS patients

can be very diverse; though patients

are often classified with their primary

symptom e.g. diarrhoea predominant,

constipation predominant or alternating

(episodes of fluctuating constipation and

diarrhoea). Associated or supportive

symptoms of IBS should also be

recognised and would typically include

some of the symptoms opposite.

Other symptoms also reported by IBS

patients include excessive flatulence,

nausea, backache, lethargy and bladder

symptoms.

Treatment of IBS can include a variation

of the administration of medication (i.e.

antispasmodics, anti-diarrhoeals, laxatives

or anti-depressants), lifestyle changes and

diet therapy.

New diet therapy for IBS

Irritable Bowel Syndrome (IBS) is a functional bowel disorder; meaning there is an impaired

gastrointestinal function with no identified structural disturbances to the gut or biochemical

pathology. IBS has an estimated prevalence of 10-20%, and forms around 40-60% of

gastroenterologists’ referrals.

Figure 1

ASSOCIATED

OR SUPPORTIVE

SYMPTOMS OF IBS

• Less than 3 bowel movements

per week

• More than 3 bowel

movements in a day

• Hard or lumpy stools

(BSC type 1-2)

• Loose or watery stools

(BSC type 7)

• Straining during a bowel

movement

• Urgency to open bowels

• Incomplete evacuation

• Presence of mucus with stool

• Abdominal distension/

bloating

The Low

FODMAP

Diet