Symptoms of IBS

Irritable bowel syndrome is characterized by symptoms of abdominal discomfort or pain, usually in the lower abdomen (although the location and intensity are variable, even at different times within the same person), and altered bowel habit (change in frequency or consistency) – chronic or recurrent diarrhea, constipation, or both – either mixed or in alternation.

Abdominal pain has been reported as primarily crampy or a generalized ache with superimposed periods of abdominal cramps, although sharp, dull, gas-like, or nondescript pains are also common. The abdominal discomfort or pain are usually relieved with a bowel movement.

Some or all of IBS symptoms can occur at the same time – some symptoms may be more pronounced than others.

There are no physical findings or diagnostic tests that confirm the diagnosis of IBS. Diagnosis involves identifying certain symptoms consistent with the disorder and excluding other medical conditions that may have a similar clinical presentation. The symptom-based Rome diagnostic criteria for IBS emphasize a positive diagnosis rather than exhaustive tests to rule out other diseases. These criteria are based on the presentation of a specific set of symptoms. In addition, a detailed history, a physical examination, and limited diagnostic tests help confirm this diagnosis with a high level of confidence. Extensive testing may be reserved for specific situations.

Other Symptoms

Upper gastrointestinal (GI) symptoms are commonly reported by IBS patients with 25% to 50% of patients reporting...

• Heartburn
• Early feeling of fullness (satiety)
• Nausea
• Abdominal fullness
• Bloating

Other GI symptoms that many patients also report include...

• Intermittent upper abdominal discomfort or pain (dyspepsia)
• Feelings of urgency (the need to find a restroom fast)
• Feeling of "incomplete" bowel emptying

Many IBS patients also report non-gastrointestinal symptoms that may be due to the coexistence or overlap of IBS with another condition such as fibromyalgia, chronic fatigue syndrome, or interstitial cystitis such as...

• Fatigue
• Muscle pain
• Sleep disturbances
• Sexual dysfunction

Other symptoms may occur that tend to correlate with the severity of the IBS such as...

• Low back pain
• Headache

Symptoms can vary and sometimes seem contradictory, such as alternating diarrhea and constipation.

The symptoms of IBS are produced by abnormal functioning of the nerves and muscles of the bowel. In IBS there is no evidence of a structural disease, yet, something – a "dysregulation" between the brain, the gut, and the central nervous system – causes the bowel to become "irritated," or overly sensitive to stimuli. Symptoms may occur even in response to normal events.

Symptoms NOT Characteristic of IBS

Anemia, blood in the stools, unexplained weight loss, or fever are not characteristic of IBS. You should alert your physician immediately if you are experiencing these symptoms.

Other signs or symptoms that call for special consideration before symptoms can be attributed to IBS include:

• Age of 50 or older
• Nighttime symptoms that awake the individual
• Change in the symptom quality (e.g., new and different pain)
• Recent use of antibiotics
• A family history of other gastrointestinal diseases like inflammatory bowel disease or cancer.