Irritable Bowel Syndrome (IBS): Symptoms, Causes, Diagnosis, and Management Strategies
Primary GI Symptoms (Rome IV Criteria)
Recurrent abdominal pain ≥1 day/week in last 3 months, associated with ≥2 of: related to defecation, change in stool frequency, change in stool form.
- Diarrhea (IBS-D), constipation (IBS-C), or mixed (IBS-M)
- Bloating, distension
- Mucus in stool
- Incomplete evacuation, urgency
Extra-Intestinal Symptoms
- Fatigue, headache, back/joint/muscle pain
- Anxiety, depression
- Skin rashes (less common)
Pathophysiology
Gut-brain axis dysregulation, visceral hypersensitivity, altered motility, microbiome changes, low-grade inflammation, post-infectious triggers.
Management
- Diet: Low FODMAP, soluble fiber, trigger avoidance
- Lifestyle: Regular exercise, stress reduction, sleep hygiene
- Medications: Antispasmodics, laxatives, antidiarrheals, neuromodulators (low-dose TCAs, SSRIs)
- Psychological: CBT, gut-directed hypnotherapy
See a gastroenterologist to exclude red flags (weight loss, bleeding, anemia, family history of IBD/colorectal cancer).
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