Confirming a diagnosis of irritable bowel syndrome is crucial. The primary aim should be to establish the person's symptom profile, with abdominal pain or discomfort being a key symptom. It is also necessary to establish the quantity and quality of the pain or discomfort, and to identify its site (which can be anywhere in the abdomen) and whether this varies. This distinguishes irritable bowel syndrome from cancer-related pain, which typically has a fixed site.

When establishing bowel habit, showing people the Bristol stool form scale may help them with description, particularly when determining quality and quantity of stool. People presenting with irritable bowel syndrome symptoms commonly report incomplete evacuation/rectal hypersensitivity, as well as urgency, which is increased in diarrhoea-predominant irritable bowel syndrome. About 20% of people experiencing faecal incontinence disclose their incontinence only if asked. People who present with symptoms of irritable bowel syndrome should be asked open questions to establish the presence of such symptoms (for example, 'tell me about how your symptoms affect aspects of your daily life, such as leaving the house'). Healthcare professionals should be sensitive to the cultural, ethnic and communication needs of people for whom English is not a first language or who may have cognitive and/or behavioural problems or disabilities. These factors should be taken into consideration to facilitate effective consultation.

NICE produces information for the public that summarises, in plain English, the recommendations that NICE makes to healthcare and other professionals.

NICE has written information for the public explaining its guidance on irritable bowel syndrome.

Patients and healthcare professionals have rights and responsibilities as set out in the NHS Constitution for England – all NICE guidance is written to reflect these. Treatment and care should take into account individual needs and preferences. People should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If someone does not have the capacity to make decisions, healthcare professionals should follow the Department of Health's advice on consent, the code of practice that accompanies the Mental Capacity Act and the supplementary code of practice on deprivation of liberty safeguards. In Wales, healthcare professionals should follow advice on consent from the Welsh Government.

If the person is under 16, healthcare professionals should follow the guidelines in Seeking consent: working with children. If a young person is moving between paediatric and adult services their care should be planned and managed according to the best practice guidance described in the Department of Health's Transition: getting it right for young people.

19 October 2012 Minor maintenance update.