Multidisciplinary Diagnosis and Management of Irritable Bowel Syndrome: Nursing Care, Pharmaceutical Management, Radiological Assessment, and Emergency Care

Abstract

Background: Irritable bowel syndrome (IBS) is a common disorder of gut–brain interaction characterized by recurrent abdominal pain and altered bowel habits, including constipation, diarrhea, or both. Its multifactorial pathophysiology and substantial impact on quality of life necessitate individualized, multidisciplinary management involving dietary modification, pharmacological treatment, and psychological interventions. Aim: This review aims to summarize current evidence regarding the diagnosis and management of IBS, emphasizing dietary and lifestyle interventions, probiotics, symptom-directed pharmacotherapy, and brain–gut behavioral therapies. Methods: A narrative review approach was used to synthesize the provided literature concerning the diagnosis, investigation, and treatment of IBS. Evidence from systematic reviews, meta-analyses, randomized controlled trials, and observational studies was considered across major therapeutic approaches and IBS subtypes. Results: IBS diagnosis relies primarily on symptom-based criteria, supported by targeted investigations to exclude relevant organic disorders. Traditional dietary advice is recommended as first-line management, while a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet may benefit patients with persistent symptoms under specialist dietitian supervision. Evidence supporting probiotics remains uncertain. Treatment should be tailored to predominant symptoms: laxatives are appropriate first-line options for constipation-predominant IBS, whereas secretagogues may benefit patients with inadequate responses. Antidiarrheals, 5-hydroxytryptamine-3 receptor antagonists, and rifaximin provide options for diarrhea-predominant symptoms. Antispasmodics, peppermint oil, and low-dose tricyclic antidepressants may alleviate abdominal pain. Cognitive behavioral therapy and gut-directed hypnotherapy can improve persistent symptoms and quality of life. Conclusion: Effective IBS management requires an individualized, multidisciplinary approach combining appropriate lifestyle measures, symptom-directed medications, and behavioral interventions according to treatment response and patient preferences.