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K58.0 – Irritable Bowel Syndrome with Diarrhoea
K58.0 is the ICD-10 code for irritable bowel syndrome with diarrhoea – a functional bowel disorder causing recurring diarrhoea and abdominal pain with no identifiable organic cause.
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K58.0 is the ICD-10 code for irritable bowel syndrome with diarrhoea – a functional bowel disorder causing recurring diarrhoea and abdominal pain with no identifiable organic cause.
What does K58.0 mean?
The diagnostic code K58.0 is part of the International Classification of Diseases (ICD-10) and stands for irritable bowel syndrome (IBS) with diarrhoea. It is a functional gastrointestinal disorder in which no structural or organic abnormalities can be found, yet patients experience significant and often debilitating symptoms affecting their quality of life.
Causes
The exact causes of IBS with diarrhoea are not yet fully understood. Several contributing factors have been identified:
- Altered gut motility: Accelerated intestinal transit leads to loose or watery stools.
- Visceral hypersensitivity: Heightened pain perception in the intestines in response to normal stimuli.
- Gut microbiome imbalance (dysbiosis): Disruption of intestinal bacteria may impair gut function.
- Post-infectious IBS: May develop following a gastrointestinal infection.
- Psychosocial factors: Stress, anxiety, and depression are closely linked to IBS.
- Dietary triggers: Certain foods (e.g., high-FODMAP foods, caffeine, fatty meals) may provoke symptoms.
Symptoms
IBS with diarrhoea (K58.0) is characterised by the following typical complaints:
- Recurrent, often urgent diarrhoea (more than 3 bowel movements per day)
- Abdominal pain and cramping that improves after bowel movements
- Abdominal bloating and flatulence
- Feeling of incomplete bowel emptying
- Mucus in the stool
- Alternation between diarrhoea and normal stool consistency
Symptoms are chronic or recurrent and typically present for at least 6 months.
Diagnosis
The diagnosis of K58.0 is an exclusion diagnosis, meaning that organic conditions must first be ruled out, including:
- Inflammatory bowel diseases (e.g., Crohn's disease, ulcerative colitis)
- Coeliac disease (gluten intolerance)
- Infectious bowel diseases
- Colorectal cancer
- Lactose or fructose intolerance
Diagnostic procedures typically include:
- Detailed medical history and physical examination
- Blood count, inflammatory markers (CRP, ESR)
- Stool tests (including faecal calprotectin)
- Colonoscopy with biopsy
- Abdominal ultrasound if indicated
The Rome IV criteria are the internationally accepted standard for diagnosing irritable bowel syndrome.
Treatment
While IBS cannot currently be cured, symptoms can be well managed. Treatment is individualised and typically includes several approaches:
Dietary Modifications
- Low-FODMAP diet: Reduction of fermentable carbohydrates has been shown to be effective in clinical studies.
- Avoidance of personal triggers (e.g., caffeine, fatty foods, alcohol)
- Regular meals and adequate fluid intake
Pharmacological Treatment
- Loperamide: To reduce stool frequency and improve stool consistency
- Antispasmodics (e.g., hyoscine butylbromide, mebeverine): For abdominal cramping
- Probiotics: May stabilise the gut microbiome and relieve symptoms
- Low-dose antidepressants (e.g., tricyclic antidepressants): For severe cases with concurrent psychological burden
Psychotherapeutic and Complementary Approaches
- Cognitive behavioural therapy (CBT)
- Gut-directed hypnotherapy
- Stress management and relaxation techniques (e.g., yoga, progressive muscle relaxation)
References
- Layer P. et al. – S3 Guideline on Irritable Bowel Syndrome. Zeitschrift für Gastroenterologie, 2021. AWMF Registration No. 021-016.
- Lacy B.E. et al. – Bowel Disorders. Gastroenterology, 2016;150(6):1393–1407. (Rome IV Criteria)
- World Gastroenterology Organisation (WGO) – Irritable Bowel Syndrome: A Global Perspective. WGO Global Guidelines, 2015. Available at: www.worldgastroenterology.org
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