Irritable Bowel Syndrome (IBS)
Description General Measures Medicine Treatment Referral ICD-10 code: K58.0/K58.9 DESCRIPTION IBS (also known as “spastic colon” or “irritable colon”) is defined as recurrent abdominal pain that has occurred at least one day per week in the last three months on average, and is associated with two or more of the following: Related to defecation. Associated with a change in stool frequency. Associa
ICD-10 code: K58.0/K58.9
DESCRIPTION
- IBS (also known as “spastic colon” or “irritable colon”) is defined as recurrent abdominal pain that has occurred at least one day per week in the last three months on average, and is associated with two or more of the following:
- Related to defecation.
- Associated with a change in stool frequency.
- Associated with a change in stool form (appearance).
- The diagnosis is suggested by a protracted and intermittent history of these symptoms which are frequently more pronounced when there is also stress.
- It is a functional disorder, most commonly seen in women between the ages of 15 and 45 years.
GENERAL MEASURES
For patients with an established diagnosis:
- Reassure patient while their symptoms are not due to life-threatening disease, they can have a significant impact on quality of life and should be managed appropriately.
- Patients with constipation may benefit from a high fibre/bran diet.
- Warn about temporary increased flatus and abdominal distension.
- High fibre/bran diets do not have a significant effect on global IBS (i.e. all symptoms).
- Dietary advice by dietician.
MEDICINE TREATMENT
- Not specifically indicated.
- Based on patients’ predominant symptoms.
- Short-term symptomatic treatment for spasms, diarrhoea and/or constipation.
Abdominal cramps:
See: Abdominal pain for treatment with anti-spasmodics.
For constipation predominant IBS:
See: Constipation for treatment with laxatives.
For diarrhoea predominant IBS:
See: Diarrhoea for treatment with anti-diarrhoeals.
Diarrhoea, Acute in Children
Diarrhoea, Acute, Without Blood, in Adults
Diarrhoea, Chronic, in Adults
Diarrhoea, Persistent in Children
REFERRAL
- Blood or mucous in the stool.
- Weight loss.
- Age > 50 years of age.
- Features suggestive of IBD.
Click here for the NEMLC Recommendations for medicine amendments (2020-4 review cycle).
Standard Treatment Guidelines And Essential Medicines List For South Africa, Primary Healthcare, 2020-4_Version 1_June 2024
Chapter 2: Gastro-Intestinal Conditions, 2.12 Irritable Bowel Syndrome (IBS)