Guidelines for the management of Irritable Bowel Syndrome

Robin Spiller ^1*, Q Aziz ², F Creed ³, A Emmanuel ⁴, L Houghton ⁵, P Hungin ⁶, R Jones ⁷, D Kumar ⁸, G Rubin ⁹, N Trudgill ¹⁰ and P Whorwell ¹¹

¹ University Hospital, Nottingham, United Kingdom
² Department of Gastroenterology, St Barts & Royal London Hospital, United Kingdom
³ University Department of Psychiatry, Manchester Royal Infirmary, United Kingdom
⁴ Digestive Disorders Institute, University College Hospital, United Kingdom
⁵ Neurogastroenterology Unit, Wythenshawe Hospital, United Kingdom
⁶ Centre for Integrated Research, University of Durham, United Kingdom
⁷ Department of General Practice and Primary Care, Kings College London, United Kingdom
⁸ Department of Surgery, St George�s Hospital, United Kingdom
⁹ University of Sunderland, United Kingdom
¹⁰ Sandwell General Hospital, West Bromwich, United Kingdom
¹¹ University Hospital of South Manchester, United Kingdom

^* To whom correspondence should be addressed. E-mail: robin.spiller{at}nottingham.ac.uk.

Accepted 1 May 2007

Abstract

Irritable bowel syndrome (IBS) is a chronic, relapsing gastrointestinal problem, characterised by abdominal pain, bloating and changes in bowel habit. While the precise prevalence and incidence depends on the criteria used, all studies agree that it is a common disorder, affecting a substantial proportion of individuals in the general population, and presenting frequently to general practitioners and to specialists. IBS is troublesome, with a significant negative impact on quality of life and social functioning in many patients2-5, but is not known to be associated with the development of serious disease or with excess mortality. IBS generates significant healthcare costs both direct, due to IBS symptoms and associated disorders as well as indirect, due to time off work.

Keywords: irritable bowel syndrome, management, constipation, diarrhoea, bloating

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