Although IBS has a number of symptoms, including diarrhea and constipation, one symptom typically predominates Table 01. Sometimes diarrhea is the chief complaint during an irritable bowel attack. In such cases, patients may feel a strong need to relieve themselves many times throughout the day, and then pass loose, watery stools. When constipation predominates, patients may have fewer than three bowel movements a week, and pass small, hard stools after straining on the toilet. Some IBS patients experience alternating bouts of diarrhea and constipation.
Others with irritable bowel feel as though they are not able to void completely. They may also feel full and bloated, and pass excessive amounts of gas. Most patients experience some degree of abdominal pain or discomfort that usually is relieved after a trip to the bathroom.
Table 1. Characteristics of IBS
Diarrhea-predominant IBS More than three bowel movements per day Loose watery stools Urgency more than 25% of the time Pain-predominant IBS Abdominal pain Cramping or aching that is relieved by a bowel movement or flatulence Bloating-predominant IBS Feeling full or bloated Excessive flatulence Predominant rectal dissatisfaction Feeling of incomplete bowel voiding Constipation-predominant IBS Fewer than three bowel movements per week Lumpy hard stools Straining during bowel movements IBS with alternating bowel habit Alternating episodes of diarrhea and constipation
About 15% of Americans have IBS, but many do not seek treatment. Although IBS affects both sexes, it is reported more frequently in women. Women with IBS seem to have more symptoms during their menstrual periods, which suggests that reproductive hormones may increase IBS symptoms. Although it has long been thought that anxiety, depression, and other mental illnesses were more common in those with IBS, recent studies have found this to be untrue. The psychological distress doctors assumed was the cause of IBS actually appears to be the result of coping with the overwhelming negative impact IBS can have on one's life. Reliable research now suggests IBS to be strictly a physical problem that is sometimes accompanied by a psychosocial component.
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