Reviewed on : 3 Apr 2024

Reviewed by : Dr Ben Disney, UHCW

Expires : 3 Apr 2026

Irritable Bowel Syndrome

Patients <45 years of age with symptoms of IBS for 3 months and no red flag symptoms.

These guidelines also apply to patients with chronic diarrhoea (Anyone above 45 years or with red flags should be referred regardless)

Pre-Referral Investigations Flowchart

Please click here for downloadable IBS pre-referral investigations flow chart.

Pre-referral investigations:

1 Blood tests – FBC, TSH, CRP, calcium, coeliac serology
2 Stool sample –
a. Faecal Calprotectin
i. <50 – likely to be IBS.
ii. 50-250 – intermediate. Repeat sample after 4-6 weeks. If still raised refer to Gastroenterology.
iii. >200 – consistent with bowel inflammation. Refer to Gastroenterology.
b. Stool Culture and clostridium difficile toxin

Treatment:

1. Dietary advice – follow BDA IBS Food facts advice.
2. Target the symptom e.g. peppermint, antispasmodics, laxatives, anti-diarrhoeal medication.

Referral threshold:
Refer if the diagnosis is in doubt or if usual management has failed

Useful information

Bristol Stool Chart

BDA IBS and Diet

Click on image below for downloadable version