Expertise Details




• Irritable bowel syndrome (IBS) is a benign, chronic symptom complex of altered bowel habits and abdominal pain.


• No organic cause can be found.

• Altered GI motility occurs in the form of exaggerated gastrocolic reflex, altered gastric emptying, increased small bowel contractions and increased small intestinal transit.

• Neurotransmitters such as serotonin may be an important factor.

• Psychological disturbances like anxiety, tension and excessive worry are all aetiologically significant.

• Certain foods may precipitate an attack.

Clinical Features

• Three clinical variants:

   • Those with spastic colitis, having primarily chronic abdominal pain and constipation (IBS with constipation or constipation-predominant IBS-at least 25% of stools are hard and fewer than 25% are loose or watery).

   • Those with chronic intermittent, watery diarrhoea often without pain (IBS with diarrhoea or diarrhoea-predominant IBS-at least 25% of stools are loose or watery and fewer than 25% are hard).

   • Those with both features and alternating diarrhoea and constipation (mixed IBS-at least 25% of stools are loose or watery and at least 25% are hard).

• More common in females of the age group 20-40 years.

• Abdominal pain is the most common symptom. Pain is referred to left or right iliac fossa or hypogastrium.

• Pain often provoked by food and relieved by defecation.

• Diarrhoea is often painless, occurs in the morning but never at night.

• In constipation-predominant IBS, stools are described as pellet like, ribbon like or pencil like.

• Mucus may or may not be present.

• Postprandial tenesmus is common, due to an exaggerated gastrocolic reflex.

• Other symptoms are abdominal distension, feeling of incomplete evacuation of rectum, excessive flatus, dyspepsia, heart burns, frequency and dysuria.



• Prime aim of investigations is to exclude organic bowel diseases.

   • Stool examination for leucocytes, parasites, ova, and occults blood

   • Routine testing for coeliac disease is advisable

   • Sigmoidoscopy

   Large amounts of mucus may be seen.   Bowel shows marked motor activity

  • Barium enema-Usually normal.        

  • Exclude lactase deficiency, hyperthyroidism and alcohol abuse.


• Reassurance of the patient and explanation for the symptoms.

• Increase the roughage content of the diet and add a bulk laxative



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