IBS should be considered in patients with abdominal pain or discomfort that is relieved by emptying the bowels or altered frequency or stool form.
For diagnosis, patients should also have two of four symptoms: altered stool passage; abdominal bloating; symptoms made worse by eating; or passage of mucus, says NICE.
It advises GPs to exclude causes other than IBS by checking full blood count, erythrocyte sedimentation rate, C-reactive protein level and antibody testing for coeliac disease.
But those with red flag indicators such as unexpected weight loss, rectal bleeding or a family history of bowel of ovarian cancer should be referred to secondary care for investigation.
GPs need to give IBS patients advice on how lifestyle, physical activity, diet and symptom-targeted medication can improve their condition. Patients should also be discourage from eating insoluble fibre such as bran, and if an increase in dietary fibre is needed, be told to eat soluble fibre, for example, oats.
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