Irritable Bowel Syndrome or IBS is primarily a disease of the gastrointestinal disorder with certain nervous components.

The symptoms of the condition vary from mild and intermittent, to severe and disabling, leading to frequent loss of work days and absenteeism.

Mild symptoms are seen among most individuals and symptomatology varies widely between persons.

Classic symptoms of IBS

Classic symptoms of IBS include (1, 2, 3) –

• Abdominal pain and cramps. The pain may be dull, cramping, aching, or sharp and stabbing. The pain is usually located in the left lower area of the abdomen or over the whole lower abdomen. Sometimes the pain may be precipitated after a meal and is relieved by defecation.
• Feeling of fullness or bloating especially after eating a heavy meal.
• Loss of appetite.
• Nausea and vomiting may be present. These may be accompanied with a meal. Some patients complain of difficulty swallowing, feeling of an obstruction in the throat, acid indigestion or heart burn, chest pain, fatigue, muscle pain or malaise etc.
• The symptoms often reduce or go away after a bowel motion and occur when there is a change in the characteristics, nature or frequency of bowel movements.
• Alternating constipation and diarrhoea. There is basically a change in stool frequency and consistency from earlier normal patterns.
• Those with diarrhoea may have loose, watery and frequent bowel motions. There may also be urgency and difficult to control motions.
• Persons with constipation develop low frequency, hard to pass bowel movements. These are often accompanied by pain and cramps.
• Sensation of inadequate evacuation of stools. After a bowel motion the patient might feel the urge to “go again” with no relief in cramps and pain.
• Passage of mucus in stools.
• Symptoms usually are often on a waxing and waning course. They may be bad for a few weeks or months and then reduce for a while in most patients. In some sufferers however the symptoms may persist most of the time.
• Symptoms such as fever, bleeding from rectum, severe pain or weight loss may be symptoms of cancer or inflammation. These may indicate a different pathology and there is need for deeper evaluation.

Triggering factors of IBS symptoms

Some triggering factors are associated with aggravation of symptoms of IBS. These include:

• Heavy meals
• Some medications
• Some foods like milk, milk products, chocolate, alcohol, coffee, tea, colas, wheat, rye or barley
• Stress and emotional upsets etc.

In addition women develop worsening of symptoms during their menses. Thus reproductive hormones may play a role in aggravating symptoms of IBS.

Depression and anxiety related symptoms are also associated with worsening of symptoms and increase suffering of patients with IBS. (2)

If there is persistent change in bowel motions and presence of other symptoms of IBS it may be time to consult a doctor.

This is especially important to rule out other gastrointestinal disorders like inflammatory bowel disease like ulcerative colitis or Crohn’s disease or gastronintestinal cancers. (4)