Clinical Features

IBS is characterized by chronic abdominal pain and changes in bowel habits

• Abdominal pain

  • Frequency, intensity, and localization generally vary widely from patient to patient

  • Typically related to defecation

• Altered bowel habits: diarrhea and/or constipation

• Other gastrointestinal symptoms

  • Nausea, reflux, early satiety

  • Passing of mucus, abdominal bloating

• Extraintestinal symptoms

  • Generalized somatic symptoms (e.g., pain or fatigue, as in fibromyalgia)

  • Disturbed sexual function

  • Dysmenorrhea

  • Increased urinary frequency and urgency

• Physical examination: normal

Red flag symptoms: nighttime diarrhea and abdominal pain, fever, bloody stools, weight loss, and acute onset of symptoms!

• IBS-D: diarrhea is the predominant symptom

• IBS-C: constipation is the predominant symptom

• IBS‑M: mixed diarrhea and constipation

• IBS-U: criteria for IBS are met but bowel movements can't be categorized into the above subgroups