Irritable Bowel Syndrome (IBS) Nursing Management

Definition
  • Irritable bowel syndrome (IBS) is a common functional disorder of GI motility not associated with anatomic changes. It is also known as spastic colon or irritable colon.
Risk Factors
  • Psychological stress
  • Prediverticular disease with changes in the bowel wall
  • Low-residue diet or a diet high in rich and stimulating or irritating foods
  • Alcohol consumption and smoking
Pathophysiology
  • IBS develops in the absence of organic disease or anatomic abnormality. Emotional stress may disturb autonomic nervous system function, leading to disrupted intestinal motility and transit time.
image by: gi.jhsps.org

image by: gi.jhsps.org

Assessment/Clinical Manifestations/Signs and Symptoms
The typical triad of findings in IBS include:
  • Abdominal pain with tenderness on palpation (abdominal pain may be localized in the left lower quadrant, be constant or intermittent and be relieved by passing flatulence or stool)
  • Altered bowel habits, such as diarrhea, or constipation. (diarrhea often alternates with constipation. Stools may contain increased mucus but seldom contain blood)
  • Absence of detectable disease. (Symptoms often mimic those of other conditions hindering the differential diagnosis). The diagnosis must first exclude any organic GI disease or abnormality)
Laboratory and diagnostic study findings:
  • Barium enema and colonoscopy reveal spasms, distention, or mucus accumulation in the intestines.
  • Complete blood count shows normal findings
  • Stool analysis shows normal findings.
Nursing Management
Teach the client measures to reduce symptoms by:
  • Eating a well balanced, high-fiber diet; avoiding gas-forming foods; and avoiding fluid intake with meals because it causes abdominal distention.
  • Adhering to a schedule of regular work and rest periods.
  • Participating in regular exercise, which reduces anxiety and increases intestinal motility.
  • Avoiding or minimizing stress-producing situations.
  • Drinking six to eight glasses of water daily (not at meals) to prevent constipation
  • Adhering to a regular eating schedule and chewing food slowly and thoroughly.
Promote client and family coping.
  • Provide the client with reassurance and emotional support to help decrease anxiety and increase his sense of control over the situation and its management.
Administer medications, which may include anticholinergics, antispasmodics, antidiarrheals, and bulk laxatives.
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