- Basic concepts
- Functional esophageal disorders
- Functional gastroduodenal disorders
- General approach to gastroduodenal disorders
- Functional dyspepsia
- Belching disorders
- Nausea and vomiting disorders
- Functional bowel disorders
- Scientific update
- Resources
- Bibliography
Search
Functional esophageal disorders / Irritable bowel syndrome
Irritable bowel syndrome
"An organic cause for the pain must be excluded, but aspects of the patient's pain behavior are of primary importance(2)" . The pain or discomfort associated with IBS is often poorly localized and may be migratory and variable. It may occur after a meal, during stress or at the time of menses(2).
Subclassification of IBS is important because it would likely be associated with different pathophysiological mechanisms and treatment choices. The Rome II committee subclassified IBS on the basis of expert opinion and attempted to incorporate stool frequency, stool form, and defecation symptoms(2). However, due to its complexity and a lack of an evidence-based approach, the subclassification was revised in the new Rome III criteria to be based solely on stool consistency, which has been supported by recent studies(3,4).
Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain and discomfort is associated with defecation or a change in bowel habit, and with features of disorders defecation(1). Although the causes of IBS have not to date been fully elucidated, it is believed that symptoms can occur as a result of a combination of factors, including visceral hypersensitivity, altered bowel motility, neurotransmitters imbalance, infection and psychosocial factors.
Rome III diagnostic Criteria* for Irritable Bowel Syndrome(1)
| Recurrent abdominal pain or discomfort** at least 3 days/ month in the last 3 months associated with 2 or more of the following: | |
| 1. | Improvement of symptomatology with defecation; and/or |
| 2. | Onset associated with a change in frequency of stool; and/or |
| 3. | Onset associated with a change in form (appearance) of stool. |
* Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis
** discomfort means an uncomfortable sensation not described as pain. In pathophysiology research and clinical trials, a pain/discomfort frequency of at least 2 days a week during screening evaluation is recommended for subject eligibility.
1 -