Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by altered bowel habits associated with chronic abdominal bloating or pain. IBS is different from IBD (Inflammatory bowel disease). About 1 in 6 people in the U.S. have some symptoms of IBS. Females are more likely to have IBS than males. Based on the bowel habits, IBS can be classified as: 1. Diarrhea-predominant (IBS-D); 2. Constipation-predominant (IBS-C); 3. IBS with mixed diarrhea and constipation(IBS-M); 4. IBS with alternating diarrhea and constipation(IBS-A). IBS is used to be a diagnosis of exclusion, which means patients with IBS have alternated bowel habits and pain, but no organic pathology can be found. Now, most experts think IBS is a GI disorder related to post bacterial infection, psychological, neurophysiological alterations, etc.

Causes and Risk Factors:

Common ones are:

  • Younger age
  • Female gender
  • Family history of IBS
  • Certain bacterial infection
  • Anxiety or depression
  • Stress

Symptoms and Signs

Common ones are:

  • Altered bowel habits
  • Diarrhea. Diarrhea mostly occurs at daytime, rarely at night.
  • Constipation
  • Diarrhea alternates with constipation
  • Abdominal pain. Pain is characteristically relieved after a bowel movement.
  • Bloating
  • Mucus in stool

Symptoms that are not support of IBS:

  • Rectal bleeding
  • Fatty diarrhea
  • Fever
  • Weight loss
  • Diarrhea happens at night
  • Old person
  • Happen suddenly

Diagnosis and Treatment

Diagnosis is based on a history and physical examination. The Rome III criteria for the diagnosis of IBS require that patients have had recurrent abdominal pain or discomfort at least 3 days per month during the previous 3 months that is associated with 2 or more of the following:

  • Relieved by defecation
  • Onset associated with a change in stool frequency
  • Onset associated with a change in stool form or appearance

Meanwhile, one or more of the following tests are necessary to rule out other illnesses that are similar to IBS:

After the diagnosis is confirmed, treatment is focused on the relief of symptoms, assurance, psychological counseling and cognitive behavior therapy, etc.

References:

  1. PubMed Health.
  2. Wikipedia.
  3. Mayo clinic online health information.
  4. Sleisenger and Fordtran's Gastrointestinal and Liver Disease- by Mark Feldman MD, et al.
  5. The Little Black Book of Gastroenterology-by David W. Hay.
  6. Principles of Clinical Gastroenterology by Tadataka Yamada, et al.


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