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What should I know about Irritable Bowel Syndrome?
Are you bothered by nagging abdominal pain, bloating, and loose painful bowel movements alternating with constipation? Do you often find a lot of mucous in your stools? Are you chronically nervous and stressed? If the answer is "Yes," and these problems are not due to some more serious, clearly identifiable bowel disease, you doctor may diagnose you with Irritable Bowel Syndrome.
Also known as "IBS," irritable bowel syndrome is one of the most common gastrointestinal disorders seen in physicians' offices. IBS is not a life-threatening condition. There is no overt disease or structural defect, in fact, the intestinal tract appears normal for the most part in people with IBS, making the diagnosis harder to pin down. Typical symptoms include distension of the abdomen, pain relieved by bowel movements, constipation alternating with diarrhea, mucous in the stools, and a feeling of incomplete bowel movements.(1, 2) These problems may be constant or they may come and go. People are generally not diagnosed as having IBS before these complaints have persisted for at least three months.
People with IBS are more likely to have other discomforts such as heartburn, pain when swallowing, fatigue, chest pain (not involving the heart), and urinary-gynecological problems.(3) IBS can mimic more serious diseases such as Crohn's disease, ulcerative colitis, colon cancer, endometriosis, and psychiatric disorders.
Mental and emotional health seems to play an important role in IBS. While there is no proof that chronic emotional stress is the cause, IBS sufferers often experience flare-ups when angry and upset, especially at mealtime.(4) It is estimated that less than half of people with IBS actually seek medical attention for it, but those that do are often diagnosed with some sort of psychiatric disorder. What's more, when psychosocial issues are addressed and dealt with, the symptoms often improve.(4) Psychosocial factors do not cause IBS, but they do have a major influence. Diagnosing IBS is largely a matter of ruling out more serious conditions. IBS generally does not cause any abnormalities that a doctor can spot during a physical exam, and routine laboratory tests are typically normal.
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1 Manning AP, et al. Towards positive diagnosis of the irritable bowel. BMJ. 1978;2:653.
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2 Borum ML. Irritable bowel syndrome. Prim Care. Sep2001;28(3):523-38,vi.
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3 Lynn RB, Friedman LS. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998: 1646-8.
4 Gaynes BN, Drossman DA. The role of psychosocial factors in irritable bowel syndrome. Baillieres Best Pract Res Clin Gastroenterol. 1999;13(3):437-52.
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