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'Referral advice' recommendation details

Irritable bowel syndrome

Guidance ID NICE 'referral advice' recommendation 'Referral advice' category
CG61 With regard to the assessment and diagnosis of patients with possible irritable bowel syndrome, healthcare professionals should consider assessment for irritable bowel syndrome (IBS) if the person reports having had any of the following symptoms for at least 6 months: - Abdominal pain or discomfort - Bloating - Change in bowel habit. All people presenting with possible irritable bowel syndrome (IBS) symptoms should be asked if they have any of the following 'red flag' indicators and should be referred to secondary care for further investigation if any are present: - unintentional and unexplained weight loss - rectal bleeding - a family history of bowel or ovarian cancer - a change in bowel habit to looser and/or more frequent stools persisting for more than 6 weeks in a person aged over 60 years. All people presenting with possible irritable bowel syndrome (IBS) symptoms should be assessed and clinically examined for the following 'red flag' indicators and should be referred to secondary care for further investigation if any are present: - anaemia - abdominal masses - rectal masses - inflammatory markers for inflammatory bowel disease. Time frame not specified
CG61 If diet continues to be considered a major factor in a person's symptoms and they are following general lifestyle/dietary advice, they should be referred to a dietitian for advice and treatment, including single food avoidance and exclusion diets. Such advice should only be given by a dietitian and may be provided in primary or secondary care. Time frame not specified
CG61 Referral for psychological interventions (cognitive behavioural therapy [CBT], hypnotherapy and/or psychological therapy) should be considered for people with irritable bowel syndrome (IBS) who do not respond to pharmacological treatments after 12 months and who develop a continuing symptom profile (described as refractory irritable bowel syndrome (IBS)). Time frame not specified

This page was last updated: 22 August 2012

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.