© Springer International Publishing AG 2017
Jakub Fichna (ed.)Introduction to Gastrointestinal Diseases Vol. 110.1007/978-3-319-49016-8_22. Clinical Features of Irritable Bowel Syndrome
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Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
Keywords
Clinical featuresIBS symptomsGender differencesThere is no specific reliable biomarker for IBS, therefore the condition is defined predominantly by symptoms; however, because of their tremendous magnitude, e.g. recurrent abdominal pain and/or discomfort, altered stool consistency and frequency, distention or bloating the diagnosis of IBS is troublesome (see Box 2.1). The occurrence of these ailments may further prompt dehydration, sleep deprivation, anxiety or lethargy and lead to time off work, social awareness and contribute to overall decrease in quality of life.
Box 2.1. Warning signs experienced by IBS patients that warrant consultation with GP
All people presenting susceptibility for IBS should be examined whether they have any “red flags” indicators such as unintentional and unexplained weight loss, progressive or unrelenting pain, family history of bowel or ovarian cancer, rectal bleeding or changes in bowel habits for more than 3 weeks, or 6 weeks in a person aged over 60 years. The presence of warning signs may point at a greater probability of disease occurrence, thus their exclusion should be done as quickly as possible.
The proper diagnosis can be made if the above-mentioned factors will be accompanied with at least two of the following:
changing in stool passage (straining, urgency, incomplete evacuation)
bloating, distention, tension, hardness
worsening of symptoms after food intake
passage of mucus.
Additionally, the occurrence of other symptoms such as nausea, backache or bladder symptoms may be used to support the diagnosis of IBS.
A detailed history of the abdominal pain and any associated symptoms e.g. the onset, duration, site, frequency and factors that can ease the pain are important characteristics in determining IBS.
Importantly, approximately 30 % of IBS-D patients experience loss of bowel control. For those patients, the symptoms impose a considerable constraint on everyday life—fear of an attack of diarrhea that limits their activities such as shopping, holidays or work.
2.1 Men Versus Women and IBS
Gender differences in IBS are well-established—the rate of IBS in general is 1.5–3- fold higher in women than men. Women are more sensitive and seek support from healthcare much more frequently. Moreover, they are able to depict their condition more precisely in comparison to men, which can have a reflection in current general rate.
The classic example of IBS patient is a young woman experiencing abdominal pain that is relieved by passage of multiple lose liquid stools. Her symptoms generally appear for more than 3 months and can be exacerbated by e.g. stress or diet intolerance. Worth mentioning, due to late luteal and early menses phases women frequently report nausea and other extraintestinal symptoms.
Overall, women are twice as likely as men to suffer from constipation-associated symptoms such as bloating, straining, abdominal distension and feelings of incomplete evacuation. Men tend towards diarrhea-associated symptoms, including watery stools, enhanced stool frequency, abdominal pain and bloating [8].
2.2 Abdominal Pain
Visceral hypersensitivity is present in all IBS subtypes albeit its intensity shifts from mild to severe.
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