Clinical manifestations and diagnosis of irritable bowel syndrome in adults
- Arnold Wald, MD
Arnold Wald, MD
- Professor of Medicine
- University of Wisconsin School of Medicine and Public Health, Madison
Irritable bowel syndrome (IBS) is a gastrointestinal syndrome characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. It is the most commonly diagnosed gastrointestinal condition. The prevalence of IBS in North America estimated from population-based studies is approximately 10 to 15 percent [1-6]. A population-based study in Europe found an overall prevalence of 11.5 percent (a value similar to that noted in reports in the United States); however, the prevalence varied widely among countries .
IBS affects men and women, young patients, and older adults. However, younger patients and women are more likely to be diagnosed with IBS . A systematic review estimated that there is an overall 2:1 female predominance in North America .
Only about 15 percent of those affected actually seek medical attention [1,2,9-11]. Nevertheless, the absolute number of patients is still so large that IBS in its various forms comprises 25 to 50 percent of all referrals to gastroenterologists . IBS also accounts for a significant number of visits to primary care physicians, and is the second highest cause of work absenteeism after the common cold . IBS has been associated with increased health care costs, with some studies suggesting annual direct and indirect costs of up to $30 billion .
This topic review will discuss the clinical manifestations and diagnosis of IBS. The pathophysiology and therapy of this disorder are presented separately. (See "Pathophysiology of irritable bowel syndrome" and "Treatment of irritable bowel syndrome in adults".)
Patients with irritable bowel syndrome (IBS) can present with a wide array of symptoms which include both gastrointestinal and extraintestinal complaints. However, the symptom complex of chronic abdominal pain and altered bowel habits remains the nonspecific yet primary characteristic of IBS .
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- CLINICAL MANIFESTATIONS
- Chronic abdominal pain
- Altered bowel habits
- - Diarrhea
- - Constipation
- Other gastrointestinal symptoms
- Extraintestinal symptoms
- DIAGNOSTIC CRITERIA
- DIAGNOSTIC APPROACH
- Diarrhea-predominant IBS
- Constipation-predominant IBS
- Mixed IBS
- Refractory symptoms
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS