09/10/2025
مع اشهر مرض في ال GIT
Snap shots in IBS :
Diagnosis & Treatment!
IBS affects 4–11% globally and is one of the most common GI conditions seen in primary care.
Here's what you need to know:
What is IBS?
IBS is a chronic GI disorder marked by abdominal pain + changes in bowel habits
There are 3 main subtypes:
🔹 IBS-C (Constipation)
🔹 IBS-D (Diarrhea)
🔹 IBS-M (Mixed)
Diagnosing IBS:
Rome IV Criteria
No single test confirms IBS.
Diagnosis is symptom-based:
• Recurrent abdominal pain ≥1 day/week
• Related to defecation or change in stool frequency/form
• Symptoms present for ≥6 months
When should you order labs/imaging?
Not everyone with IBS symptoms needs a full workup.
Per AGA Guidelines:
✅ CBC, CRP, celiac serologies (esp. in IBS-D)
🚫 Avoid over testing unless red flags:
bleeding, weight loss, anemia, family history of IBD or CRC
4️⃣ FDA-Approved Medications for IBS
✅ IBS-C
• Lubiprostone
• Linaclotide
• Plecanatide
• Tenapanor
✅ IBS-D
• Rifaximin
• Eluxadoline
• Alosetron
⚠️ Tegaserod was FDA-approved for IBS-C in women, but later withdrawn from the market.
Treatment Approach:
This stepwise tool helps guide you:
🔹 Start with lifestyle, fiber, and
antispasmodics
🔹 Add prescription medications if no relief
🔹 Consider TCAs, SNRIs, or CBT for pain or psychological symptoms
Don’t forget the brain-gut axis.
Psychological symptoms
(anxiety, depression) are common in IBS.
Brain Gut-directed therapy (CBT, hypnosis) or medications like TCAs and SNRIs can be effective for abdominal pain or refractory cases
Key takeaways:
✅ IBS is a clinical diagnosis
✅ Only investigate if red flags are present
✅ Tailor treatment to the IBS subtype
✅ Start with diet, lifestyle, and reassurance
✅ Escalate to prescription meds if symptoms persist
https://t.me/msaidelgamalclinicalpearls
إستشاري امراض الباطنة والكبد د محمد الجمال