Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a common, debilitating, multi-factorial, functional gastrointestinal disorder where a definitive aetiology has not been established and no uniformly successful treatment exists. The condition is very prevalent in developed countries with IBS symptoms experienced by 8-22% of the population. (1)
IBS is characterised by a combination of symptoms and signs, such as abdominal pain, constipation (IBS-C), diarrhoea (IBS-D) — or alternating between both (IBS-A) — a noted change in both the frequency and consistency of stools, rectal mucus due to hyper-secretion of colonic mucus, dyspeptic symptoms including anorexia, flatulence, gastro-oesophageal reflux (GOR) and nausea, and an emotional component where anxiety and/or depression are often noted. Abdominal pain is often relieved following defecation. . Originally, diagnosis for IBS was made based on the Rome I Criteria. This previous criteria specified that there should be at least 3 months of abdominal pain, either continuous or recurrent, that is relieved by defecation &/or is associated with either a change in the frequency or consistency of the stool. Conversely, the Rome II Criteria differs from that of the Rome I in that it specifies that the abdominal pain should be present either continuously, or recurring for a period of 12 weeks or >. Both the Rome I & Rome II Criteria are consistent in their description of what constitutes accompanying symptoms, i.e., relief of abdominal pain following defecation, &/or associated changes in both the frequency & consistency of the stool, but the Rome II Criteria is more specific in stipulating that at least 2 of these accompanying symptoms must be noted, along with abdominal pain. Although the Rome I Criteria was also quite detailed in specifying that an individual had to have two or more associated symptoms of IBS, e.g., altered stool frequency of more than 3 per day or < 3 per week; abdominal distension; bloating; passage of mucus, etc, > 25% of the time, the newer Rome II Criteria has helped in simplifying the diagnosis of IBS.
