gastrointestinal disorders
Irritable Bowel Syndrome (IBS)
Symptoms and Signs of IBS
Irritable bowel syndrome tends to begin in adolescence and the 20s, causing bouts of symptoms that recur at irregular periods. Onset in late adult life is also possible but less common. Symptoms of IBS rarely rouse the sleeping patient. Symptoms are often triggered by food or by stress. Patients have abdominal discomfort, which varies considerably but is often located in the lower abdomen, is steady or cramping in nature, and is related to defecation. In addition, abdominal discomfort is temporally associated with alterations in stool frequency (increased in diarrhea-predominant IBS and decreased in constipation-predominant IBS) and consistency (ie, loose or lumpy and hard). Pain or discomfort related to defecation is likely to be of bowel origin; that associated with exercise, movement, urination, or menstruation usually has a different cause. Although bowel patterns are relatively consistent in most patients, it is not unusual for patients to alternate between constipation and diarrhea. Patients may also have symptoms of abnormal stool passage (straining, urgency, or feeling of incomplete evacuation), pass mucus, or complain of bloating or abdominal distention. Many patients also have symptoms of dyspepsia. Extraintestinal symptoms (eg, fatigue, fibromyalgia, sleep disturbances, chronic headaches) are common. 