Irritable Bowel Syndrome (IBS)

A common but sometimes overlooked condition, benign, not life-threatening, but which can definitely reduce the quality of life, is irritable bowel syndrome (IBS). The diagnosis is based upon reported symptoms, as there are no findings on performing a physical examination, blood tests, or imaging studies.

Diagnosis of IBS is made by confirming the patient has experienced abdominal pain at least once per week for the past 3 months, and the first episode of pain at least 6 months ago. IBS abdominal pain is associated with at least two of the following three symptoms:

• Pain related to defecation;

• Change in frequency of stool;

• Change in form (appearance) of stool.

The patient should be <50 years of age at onset and not have any of the following to suggest a more severe underlying condition:

• No previous colon cancer screening, and presence of symptoms;

• Recent change in bowel habit;

• Evidence of overt GI bleeding, including positive fecal occult blood test;

• Evidence of iron-deficiency anemia on blood testing;

• Nocturnal pain or passage of stools;

• Unintentional weight loss;

• Family history of colorectal cancer or inflammatory bowel disease;

• Palpable abdominal mass or lymphadenopathy;

Measurement of fecal calprotectin may aid in distinguishing IBS from an inflammatory bowel disease (IBD). Calprotectin is derived from neutrophils, so it serves as an acute phase reactant correlating with inflammation, as with IBD but not IBS.