Irritable bowel syndrome

Definition, prevalence, and natural history

Irritable bowel syndrome (IBS) is a combination of chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities, which is attributed to the intestines and associated with symptoms of pain, disturbed defecation, and/or symptoms of

Box 14.2 Rome III criteria for the diagnosis of irritable bowel syndrome

Recurrent abdominal pain or discomfort on at least 3 days/month in the last 3 months associated with two or more of the following:

  • 1 Improvement with defecation.
  • 2 Onset associated with change in frequency of stool.
  • 3 Onset associated with change in form of stool.

From Drossman DA. The Functional Gastrointestinal Disorders and the Rome III Process. GASTROENTEROLOGY 2006;130:1377-1390.

bloating and distention. The prevalence in industrialized countries is 9-12 per cent. Women are more commonly affected than men and the incidence of the illness is higher in those aged below age 45 than those aged 45 and over. Patients tend to report episodes of IBS, with duration of up to 5 days. Individuals may develop a remission after a series of symptomatic episodes, but there is paucity of literature on the natural history of the illness.3 The Rome criteria have been developed to standardize diagnosis and aid the selection of patients for clinical trials (see Box 14.2).

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