Irritable Bowel Syndrome

What is IBS?

IBS is a common disorder associated with chronic pelvic pain. It is a dunctional bowel disorder that can present with bloating, cramping, diarrhea, constipation and pain.

What causes IBS?

Noone is 100% clear as to what causes IBS. It is becoming more evident that there is an association between the function of the bowel and the signals it receives from the brain. There is some disturbance in disturbance in the interaction between the intestines, the brain, and the autonomic nervous system that alters regulation of bowel motility (motor function) or sensory function.

How is it diagnosed?

It is diagnosed when a patient's symptoms meet the Rome II criteria for IBS which are:

At least 12 weeks, which need not be consecutive, in the preceding 12 months of abdominal discomfort or pain that has two out of three features:

1. Relieved 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.

Symptoms that Cumulatively Support the Diagnosis of IBS:

Abnormal stool frequency (may be defined as greater than 3 bowel movements per day and less than 3 bowel movements per week);
Abnormal stool form (lumpy/hard or loose/watery stool);
Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation);
Passage of mucus;
Bloating or feeling of abdominal distension.

These symptoms need to be interpreted with caution especially in the evaluation of the bigger picture of chronic pelvic pain. A psychiatric evaluation is always recommended in patients with symptoms of IBS as depression and anxiety are common components.

What are the treatments for IBS?

There are many different possible treatments for IBS including medical therapy, dietary modification, psychotherapy, and relaxation techniques. These modalities all need to be individualized depending on your predominant symptoms and other medical problems, and other possible causes of pelvic pain.

Click here to view the NIH's learning module on IBS