Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome is a functional gut-brain disorder that causes recurrent abdominal pain tied to defecation, with a change in stool frequency or form. The bowel shows no inflammation or structural damage, which is what separates it from Crohn's disease and ulcerative colitis, and colon cancer risk is not raised. It is more common in women and usually begins in the teens to early adulthood. The subtype follows the main stool pattern, IBS-C, IBS-D or IBS-M, and drugs are chosen for that pattern. The nurse reports anything IBS does not explain: rectal bleeding, unintended weight loss, fever, nocturnal symptoms, anemia, onset after about age 50 or a family history of colorectal cancer. Teaching covers a symptom and food diary, a limited low-FODMAP trial, soluble fiber increased gradually with fluids, and stress management. The client never exceeds the loperamide dose, and stops alosetron and reports new constipation or bloody stools because of its boxed warning.