Gastroenterology and hepatology
Irritable bowel syndrome
A positive diagnosis with Rome V criteria and minimal tests, the alarm features that need colonoscopy, the low FODMAP diet, subtype-directed drugs, low-dose amitriptyline (ATLANTIS) and gut-directed psychological therapy.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- IBS is a disorder of gut-brain interaction: recurrent abdominal pain linked to bowel habit, without a structural cause on basic testing. It affects about 4 to 5% of adults by Rome criteria, women about twice as often as men.
- Make a positive diagnosis from symptoms, a normal examination and a few blood and stool tests. Repeated colonoscopies and scans reinforce illness belief and rarely find anything.
- Look for alarm features. Their presence calls for investigation, not a label of IBS.
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Sources
- Therapeutic Guidelines (eTG complete): Gastrointestinal, irritable bowel syndromeAU/NZTherapeutic Guidelines Limited
- Monash University Low FODMAP DietAU/NZMonash University Department of Gastroenterology
- Rome V criteria for disorders of gut-brain interaction (Gastroenterology, 2026)Rome Foundation, 2026
- Vasant DH et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut 2021;70:1214-40British Society of Gastroenterology, 2021
- Lacy BE et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. Am J Gastroenterol 2021;116:17-44American College of Gastroenterology, 2021
- Chang L et al. AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Constipation. Gastroenterology 2022;163:118-36American Gastroenterological Association, 2022
- Ford AC et al. Amitriptyline at low-dose and titrated for irritable bowel syndrome as second-line treatment in primary care (ATLANTIS). Lancet 2023;402:1773-85The Lancet, 2023
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback