IBS Symptoms: Understanding and Recognizing Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional GI disorder (gut-brain interaction) with recurrent abdominal pain linked to defecation or bowel habit changes. No structural abnormality.

Diagnostic Criteria (Rome IV)

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 (Bristol scale)

Common Symptoms

• Abdominal pain/cramping (relieved by bowel movement)
• Diarrhea, constipation, or alternating (IBS-D, IBS-C, IBS-M)
• Bloating, distension
• Excessive gas
• Mucus in stool
• Urgency, tenesmus (incomplete evacuation)

Extra-Intestinal Symptoms

• Fatigue, headache, backache
• Anxiety, depression (bidirectional gut-brain axis)
• Sleep disturbance
• Urinary frequency, dyspareunia

Management

• Diet: Low FODMAP (evidence-based), fiber modulation, trigger avoidance.
• Lifestyle: Regular meals, hydration, exercise, stress reduction.
• Medications: Antispasmodics, laxatives, antidiarrheals, neuromodulators (low-dose TCAs, SSRIs), gut-specific antibiotics (rifaximin for IBS-D), secretagogues (linaclotide for IBS-C).
• Psychological: CBT, gut-directed hypnotherapy.

Diagnosis is clinical; rule out red flags (weight loss, bleeding, anemia, family history of GI cancer, onset >50).