Irritable%20bowel%20syndrome Signs and Symptoms

• Irritable bowel syndrome (IBS) is a chronic, relapsing functional bowel disorder characterized by abdominal pain and bloating with altered bowel habits that may affect the patient's quality of life
• There are no identifiable physical, radiologic or lab abnormalities indicative of organic disease 
  • IBS is currently considered to be a disorder of gut-brain interaction which affects gastro­intestinal (GI) motility, sensation and secretion
• It has no known association with the development of cancer, mortality or inflammatory bowel disease (IBD)

• Symptoms may be exacerbated by stress, alcohol, food, abdominal and/or pelvic surgery, a sequelae of GI infection, and/or a difficult life changing event in the patient's life

Recurrent Abdominal Pain 

• Pain is intermittent 
• Patient may describe pain as crampy in nature with variable intensity and periodic exacerbations
• Location and character of pain may vary
• Defecation or passing of flatus often provides relief

Altered Bowel Habits 

• Diarrhea, constipation, alternating diarrhea and constipation or normal bowel habits alternating with either diarrhea and/or constipation

Other GI Symptoms 

• Gastroesophageal reflux, dysphagia, early satiety, intermittent dyspepsia, nausea, noncardiac chest pain

Extraintestinal Symptoms 

• Urinary frequency and urgency, sexual dysfunction, fibromyalgia, dyspareunia, poor sleep, menstrual difficulties, lower back pain, headaches, chronic fatigue and insomnia
• The more extracolonic symptoms, the greater likelihood of having severe IBS

• Age ≥50 years old
• Nocturnal symptoms
• Hematochezia, occult blood in the stool
• Rectal bleeding
• Unintended weight loss 
• Family history of colon cancer, ovarian cancer, IBD, celiac sprue, recurring fever
• Unexplained iron-deficiency anemia
• Recent medication use (antibiotics)
• Abdominal or rectal mass
• Ascites
• Inflammatory markers for IBD
• More loose or more frequent stools or both, persisting for >6 weeks in an individual >60 years old

Other factors that may lead the clinician to perform routine diagnostic tests:

• History of travel to locations with endemic parasitic diseases
• Family history of IBD
• Relation to menstruation, consumption of known foods that cause intolerance (especially milk), artificial sweeteners, dieting products, or alcohol 
• Arthritis or skin findings on physical exam
• Signs or symptoms of malabsorption
• Signs or symptoms of thyroid dysfunction