Irritable Bowel Syndrome

Ronnie R. Pimentel

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder representing up to 25% of outpatient visits in gastrointestinal practices.1 It is twice as common in females as in males and more prevalent in young patients of high socioeconomic status. Interestingly, only one-fourth of all affected patients will seek medical attention and they seem to be those with a greater degree of somatization and psychiatric disorders. Association with other functional disorders such as migraine or fibromyal-gia is not uncommon.

Irritable bowel syndrome is a chronic condition that appears early in life and is characterized by periods of exacerbation and remission. Exacerbations are frequently associated with stressful situations or "life events." The most common symptoms are those of abdominal pain, altered bowel habits, bloating, and sensation of incomplete evacuation. The characteristics and severity of the abdominal pain vary from patient to patient but keep a particular pattern over time. The pain is often described as crampy, rarely severe, and temporarily relieved by bowel movements. Nocturnal pain, weight loss, fever, and other constitutional symptoms are typically absent.

Based on the pattern of bowel alteration, IBS can be described as diarrhea- or constipation-predominant; nevertheless, an alternating pattern in which patients go from one extreme to the other is also seen. Diarrhea-predominant IBS is more common in women. Nocturnal occurrence is quite rare and suggestive of organic etiologies. Fecal incontinence is not uncommon. In constipation-predominant cases, bloating, incomplete evacuation, and changes in stool shape, along with the presence of mucus is a typical scenario.

In an effort to standardize the clinical definition of IBS, the Rome II criteria were created. Although quite useful and widely utilized, these criteria failed to include a subgroup of IBS patients with postprandial exacerbation and those with painless, functional diarrhea.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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