Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by recurrent abdominal pain and altered bowel habits. This nursing diagnosis focuses on identifying symptoms, managing discomfort, and improving the quality of life for patients with IBS.
Causes (Related to)
IBS can affect patients in various ways, with several factors contributing to its severity and manifestation:
- Altered gut motility and sensitivity
- Dysregulation of the brain-gut axis
- Psychological stress and anxiety
- Food intolerances or sensitivities
- History of gastrointestinal infections
- Genetic factors such as:
- Family history of IBS
- Genetic variations affecting serotonin regulation
- Inherited pain sensitivity
- Environmental triggers including:
- Dietary factors
- Stress and life changes
- Sleep disturbances
- Hormonal changes
Signs and Symptoms (As evidenced by)
IBS presents distinctive signs and symptoms that nurses must recognize for proper diagnosis and treatment.
Subjective: (Patient reports)
- Recurrent abdominal pain or cramping
- Bloating and gas
- Changes in bowel habits
- Food sensitivities
- Stress-related symptom exacerbation
- Fatigue
- Sleep disturbances
- Anxiety about symptoms
Objective: (Nurse assesses)
- Altered bowel movements (diarrhea, constipation, or both)
- Abdominal distension
- Changes in stool consistency
- Visible signs of anxiety
- Changes in vital signs during pain episodes
- Weight changes
- Sleep pattern disruption
- Food diary patterns
Expected Outcomes
The following outcomes indicate successful management of IBS:
- The patient will report reduced frequency and severity of abdominal pain
- The patient will maintain regular bowel patterns
- The patient will identify and avoid trigger foods
- The patient will demonstrate effective stress management techniques
- The patient will maintain adequate nutrition and hydration
- The patient will report an improved quality of life
- The patient will demonstrate an understanding of IBS management strategies
Nursing Assessment
Monitor Gastrointestinal Status
- Assess bowel movement patterns
- Document stool characteristics
- Monitor abdominal pain levels
- Track dietary intake
- Note symptom triggers
Evaluate Psychological Status
- Assess stress levels
- Monitor anxiety symptoms
- Evaluate coping mechanisms
- Document sleep patterns
- Check social support systems
Assess Nutritional Status
- Monitor food intake
- Track weight changes
- Assess for food intolerances
- Document fluid intake
- Evaluate nutritional knowledge
Monitor for Complications
- Check for signs of malnutrition
- Assess for depression
- Monitor for social isolation
- Document work/life impact
- Track medication effectiveness
Review Risk Factors
- Document family history
- Assess lifestyle factors
- Review medication history
- Check stress management skills
- Monitor environmental triggers
Nursing Care Plans
Nursing Care Plan 1: Chronic Pain
Nursing Diagnosis Statement:
Chronic Pain related to altered gut motility and visceral hypersensitivity as evidenced by recurring abdominal pain and cramping.
Related Factors:
- Altered gut-brain axis
- Visceral hypersensitivity
- Psychological stress
- Dietary triggers
Nursing Interventions and Rationales:
- Assess pain characteristics and patterns
Rationale: Establishes baseline and helps identify triggers - Teach pain management techniques
Rationale: Empowers patient with self-management skills - Implement stress reduction strategies
Rationale: Reduces pain amplification through stress response
Desired Outcomes:
- The patient will report decreased pain intensity
- The patient will demonstrate effective pain management techniques
- The patient will identify and avoid pain triggers
Nursing Care Plan 2: Diarrhea
Nursing Diagnosis Statement:
Diarrhea related to altered bowel motility as evidenced by frequent loose stools and urgency.
Related Factors:
- Intestinal hypermotility
- Dietary triggers
- Stress response
- Gut microbiota alterations
Nursing Interventions and Rationales:
- Monitor stool frequency and characteristics
Rationale: Tracks severity and response to interventions - Implement dietary modifications
Rationale: Identifies and eliminates trigger foods - Maintain fluid and electrolyte balance
Rationale: Prevents dehydration and electrolyte imbalances
Desired Outcomes:
- The patient will report a decreased frequency of diarrhea
- The patient will maintain adequate hydration
- The patient will identify dietary triggers
Nursing Care Plan 3: Anxiety
Nursing Diagnosis Statement:
Anxiety related to chronic gastrointestinal symptoms as evidenced by expressed worries about symptom occurrence and social impact.
Related Factors:
- Unpredictable symptoms
- Social embarrassment
- Impact on daily activities
- Fear of symptom exacerbation
Nursing Interventions and Rationales:
- Teach relaxation techniques
Rationale: Reduces anxiety and symptom severity - Provide emotional support
Rationale: Helps patient cope with chronic condition - Develop coping strategies
Rationale: Improves management of anxiety triggers
Desired Outcomes:
- The patient will demonstrate reduced anxiety levels
- The patient will utilize effective coping mechanisms
- The patient will report an improved quality of life
Nursing Care Plan 4: Imbalanced Nutrition
Nursing Diagnosis Statement:
Imbalanced Nutrition: Less than Body Requirements related to food avoidance as evidenced by inadequate food intake and weight loss.
Related Factors:
- Fear of triggering symptoms
- Restricted diet
- Poor appetite
- Malabsorption
Nursing Interventions and Rationales:
- Monitor nutritional intake
Rationale: Ensures adequate nutrition despite restrictions - Develop safe meal plans
Rationale: Provides balanced nutrition while avoiding triggers - Educate about proper nutrition
Rationale: Improves dietary choices and nutrition status
Desired Outcomes:
- The patient will maintain adequate nutritional intake
- The patient will demonstrate weight stability
- The patient will follow a balanced meal plan
Nursing Care Plan 5: Disturbed Sleep Pattern
Nursing Diagnosis Statement:
Disturbed Sleep Pattern related to gastrointestinal discomfort as evidenced by difficulty maintaining sleep and daytime fatigue.
Related Factors:
- Abdominal pain
- Nocturnal symptoms
- Anxiety
- Stress
Nursing Interventions and Rationales:
- Assess sleep patterns
Rationale: Identifies factors affecting sleep quality - Implement sleep hygiene measures
Rationale: Improves sleep quality and duration - Manage nighttime symptoms
Rationale: Reduces sleep disruptions
Desired Outcomes:
- The patient will report improved sleep quality
- The patient will demonstrate increased energy levels
- Patient will maintain a regular sleep schedule
References
- Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
- Anastasi JK, Capili B, Chang M. Managing irritable bowel syndrome. Am J Nurs. 2013 Jul;113(7):42-52; quiz 54, 53. doi: 10.1097/01.NAJ.0000431911.65473.35. PMID: 23764698; PMCID: PMC5654469.
- Chey WD, Hashash JG, Manning L, Chang L. AGA Clinical Practice Update on the Role of Diet in Irritable Bowel Syndrome: Expert Review. Gastroenterology. 2022 May;162(6):1737-1745.e5. doi: 10.1053/j.gastro.2021.12.248. Epub 2022 Mar 23. PMID: 35337654.
- Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
- Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
- Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
- Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
- Tetali B, Suresh S. Management of irritable bowel syndrome: a narrative review. Transl Gastroenterol Hepatol. 2024 Mar 21;9:26. doi: 10.21037/tgh-23-96. PMID: 38716216; PMCID: PMC11074491.
