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Irritable bowel syndrome

Colon irritabile · Syndrom dráždivého tračníku

What it is

A gut-brain signalling disorder: real symptoms, normal-looking bowel.

Symptoms & signs

  • Cramping relieved by opening bowels
  • bloating
  • alternating diarrhoea and constipation
  • urgency
  • mucus

🚩 Get help if…

  • see a doctor soon Blood in the stool or black stools
  • see a doctor soon Weight loss without trying
  • see a doctor soon Diarrhoea waking you at night or bowel change after 50
  • see a doctor soon Fever, anaemia or a lump in the belly

Where it strikes

Medical treatment

  • Antispasmodics (mebeverine)
  • loperamide or laxatives as needed
  • low-dose amitriptyline
  • linaclotide, rifaximin
  • gut-directed CBT and hypnotherapy

Natural & lifestyle

  • Low-FODMAP diet then reintroduction
  • soluble fibre (psyllium)
  • peppermint oil capsules
  • regular meals and exercise
  • stress work
  • probiotics (strain-specific)

Emerging & experimental

  • Faecal microbiota transfer trials
  • targeted bile-acid modulators
  • virtual-reality gut hypnotherapy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • STW5 (Iberogast) herbal combination — trials show symptom relief; rare liver injury reported mixed evidence
  • Acupuncture — trials disagree mixed evidence
  • Gluten-free diet for 'gluten sensitivity' — many feel better; blinded trials often point to fructans (FODMAPs) rather than gluten mixed evidence
  • Curcumin and fennel oil — small trials early / small studies
  • Colonic irrigation — popular; no evidence, and a risk of injury anecdotal / traditional

ICD codes