According to the American Academy of Family Physicians, irritable bowel syndrome, or IBS, represents a functional disorder---not a disease---of the colon characterized by recurrent episodes of abdominal pain accompanied by alteration in bowel habits, i.e. diarrhea or constipation. Diarrhea or constipation that occur in the absence of abdominal pain suggests something other than IBS. For any pain complaint, a doctor will usually ask specific questions to determine the diagnosis and treatment.
Onset
Common triggers for IBS pain include eating and waking up in the morning. In a broader sense, many patients can also trace the onset of symptoms to a stressful event or, for women, the beginning of a menstrual period.
Duration
Physicians diagnose IBS based on the 2006 Rome Criteria, which specifies that abdominal pain due to IBS must occur at least three days of each month. Individual pain episodes usually precede an alteration in bowel habits and improve or resolve with a bowel movement.
Location
The location of IBS pain appears to vary by patient. According to Dr. Chung Owyang, chief of gastroenterology for the University of Michigan Health System, IBS pain localizes to the lower abdomen in 25 percent, the right side in 20 percent, the left side in 20 percent and the upper abdomen in 10 percent of patients. The remaining 25 percent of patients report pain in more than one location or generalized pain that cannot be attributed to a single location.
Character
Patients with IBS usually describe episodic, cramping pain, sometimes superimposed on a constant, dull ache. Most pain is mild to moderate and rarely interferes with sleep.
Associated Pain
Patients with IBS pain often complain of other kinds of nonabdominal pain such as muscle pain, back pain, headaches and genital or urinary pain. Pain may result from another functional disorder such as fibromyalgia or may radiate from the abdomen, as in the case of back pain in patients with severe constipation.
References
- American Academy of Family Physicians: Irritable Bowel Syndrome
- National Institutes of Health: What I Need to Know about Irritable Bowel Syndrome
- Irritable Bowel Syndrome (Chapter); C. Owyang; In: "Harrison's Principles of Internal Medicine, 19th edition;" A.S. Fauci et al. (eds); 2008
