How to Diagnose Irritable Bowel Syndrome


Irritable Bowel Syndrome - Diagnosis

Survey plan with irritated bowel

The diagnosis of irritable bowel syndrome is an exception diagnosis. Preliminary diagnosis is based on the Roman criteria II (1999).

Pain and / or discomfort in the abdomen for 12 weeks, not necessarily consecutive, in the last 12 months:

  • their severity decreases after defecation; and / or associated with changes in the frequency of defecation;
  • and / or are associated with changes in the consistency of the stool, and

Two or more of the following:

  • altered frequency of bowel movements (more often 3 times a day or less than 3 times a week);
  • altered stool consistency (lumpy, dense stools or watery stools);
  • change in the passage of the stool (tension during defecation, urgent urge to defecate, feeling of incomplete evacuation);
  • a passage of mucus and / or flatulence or a sensation of bloating.

The final diagnosis is made by eliminating organic pathology. The application of the Roman criteria II requires the absence of so-called "anxiety symptoms". In

this case, the sensitivity of the criteria is 65%, the specificity is 95%.

"Symptoms of anxiety excluding the diagnosis of irritable bowel syndrome

Weight loss

The appearance of symptoms older than 50 years

Symptomatics at night, forcing the patient to get up in the toilet

Weighed down family history of cancer and inflammatory diseases of the colon

Constant intense pain in the abdomen as the only and leading symptom of the defeat of the gastrointestinal tract

The recent use of antibiotics

In the presence of "symptoms of anxiety careful laboratory-instrumental examination of the patient is necessary.

Compulsory laboratory tests

Carried out to exclude "symptoms of anxiety" and diseases that occur with a similar clinical picture.

  • General blood analysis. Carried out for the exclusion of inflammatory or paraneoplastic genesis of pain abdominal syndrome.
  • Analysis of feces for the intestinal group of pathogenic bacteria (Shigella, Salmonella, Yersinia), eggs of worms and parasites. The study is carried out three times.
  • Coprogram.
  • General urine analysis.
  • Concentration of serum albumin.
  • The content in the blood of potassium, sodium, calcium.
  • Proteinogram.
  • Research of blood immunoglobulins.
  • Concentration in the blood of thyroid hormones.

For irritable bowel syndrome, there is no change in laboratory tests.

Additional laboratory tests

Conducted to identify concomitant diseases of the hepatobiliary system.

  • Serum aminotransferase, GGTF, alkaline phosphatase.
  • Concentration of total bilirubin.
  • Study for hepatitis virus markers: HBAg, Anti-HCV.

Compulsory instrumental research

  • Irrigoscopy: typical signs of dyskinesia - uneven filling and emptying, alternation of spastic reduced and extended areas and / or excessive secretion of fluid in the lumen of the intestine.
  • Colonoscopy with biopsy is an obligatory method of research, since it allows the study of organic pathology. In addition, only a morphological study of the biopsy specimens of the intestinal mucosa allows ultimately to distinguish irritable bowel syndrome from inflammatory bowel diseases. The study often provokes the symptoms of the disease due to the characteristic for the irritable bowel syndrome of visceral hypersensitivity. PHAGS with biopsy of the small intestine mucosa: conducted to exclude celiac disease.
  • Ultrasound of the abdominal cavity: allows excluding cholelithiasis, cysts and calcifications in the pancreas, volumetric abdominal cavities.
  • A test with lactose load or a diet with the exception of lactose for 2-3 weeks: for the diagnosis of latent lactase deficiency.

Additional instrumental research

Conducted in order to detail the changes found during the conduct of mandatory research methods.

  • RKT.
  • Doppler study of the vessels of the abdominal cavity.

Differential diagnosis of irritable bowel

Irritable bowel syndrome must be differentiated from the following diseases and conditions:

  • neoplasms of the large intestine; inflammatory bowel diseases; diverticular disease; dysfunction of the pelvic floor muscles;
  • neurological diseases (Parkinson's disease, autonomic dysfunction, multiple sclerosis);
  • side effects of medications (opiates, calcium channel blockers, diuretics, anesthetics, muscle relaxants, holinoblokatory); hypothyroidism and hyperparathyroidism.

Symptoms similar to the clinical picture of irritable bowel syndrome are observed when:

  • physiological conditions in women (pregnancy, menopause);
  • the use of certain products (alcohol, coffee, gas-producing products, fatty foods) - can cause both diarrhea and constipation;
  • change the habitual way of life (for example, business trips);
  • presence of ovarian cysts and uterine fibroids.

In patients with a predominance in the clinical picture of constipation, it is necessary to exclude obstruction of the colon, primarily of a tumor nature. This is especially true in patients older than 45 years, as well as in young patients with:

  1. debut disease;
  2. expressed or refractory to the treatment of symptoms;
  3. family history of colon cancer.

With the prevalence of diarrheal syndrome in symptoms, irritable bowel syndrome must be differentiated from the following diseases.

  • Inflammatory bowel disease: Crohn's disease, ulcerative colitis.
  • Infectious diseases caused byLamblia intestinalis, Entamoeba histolytica, Salmonella, Campylobacter, Yersinia, Clostridium difficile,parasitic infestations.
  • Side effects of medications (antibiotics, potassium preparations, bile acids, misoprostol, abuse of laxatives).
  • Malabsorption syndrome: sprue, lactase and disaccharidase insufficiency.
  • Hyperthyroidism, carcinoid syndrome, medullary thyroid cancer, Zollinger-Ellison syndrome.
  • Other causes: post-gastrectomy syndrome, enteropathy associated with HIV infection, eosinophilic gastroenteritis, food allergy.

If the pain syndrome prevails in the clinical picture, irritable bowel syndrome should be differentiated from the following states:

  • partial obstruction of the small intestine;
  • Crohn's disease; ischemic colitis;
  • chronic pancreatitis;
  • lymphoma of the digestive tract;
  • endometriosis (symptoms usually occur during menstruation);
  • diseases of the biliary tract.

For a differential diagnosis, colonoscopy with biopsy is very important.

Indications for consultation of other specialists

  • Infectionist - with a suspicion of the infectious nature of diarrhea.
  • Psychiatrist (psychotherapist) - for the correction of psychosomatic disorders.
  • Gynecologist - to exclude the causes of pain syndrome associated with gynecological diseases.
  • Oncologist - in case of detection of malignant neoplasms during instrumental research.

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Do not suffer discomfort! Improve your quality of life will help you gastroenterologists in NEOMED.

This is a condition in which the work of the intestine is disrupted. For IBS is characterized by paroxysmal abdominal pain, diarrhea or constipation, bloating.

Irritable bowel syndrome is a functional disease. That is, when examining a patient, as a rule, there is no evidence of any violation of the intestine and its structure, and the results of laboratory diagnosis remain within the normal range. Despite this, a person experiences quite a strong discomfort, which significantly reduces his quality of life.

Irritable bowel syndrome is more likely to affect women than men, the most dangerous age is 30-40 years.

As it was already possible to notice, complaints at IBS are very similar to other diseases of the gastrointestinal tract. However, unlike irritable bowel syndrome, they can be very dangerous and seriously threaten health. Symptoms of irritable bowel syndrome may be similar to symptoms of colitis, Crohn's disease, intestinal tumor, intestinal infection.

Therefore, if you are often and permanently worried about abdominal pain, diarrhea, bloating (flatulence), then this is an occasion to seek help from the gastroenterologist.

In the clinic NEOMED you will be able to undergo a comprehensive examination to identify the causes of your complaints and get a full treatment.

The main complaints in irritable bowel syndrome:

  • abdominal pain of varying intensity, often cramping. It can be provoked by food intake and significantly subsides after defecation.
  • bloating (flatulence), rumbling in the abdomen.
  • Diarrhea (diarrhea), can be from a liquid consistency to a mild. By frequency from several to once a day.
  • constipation, is less common than diarrhea. The chair is compact, lean.

All symptoms can be provoked by eating, especially by certain types of foods, as well as a stressful, emotionally stressful situation.

Medicine has not revealed a single-valued reason for the development of IBS.

IBS: irritable bowel syndrome

More and more people are faced with such a common functional disease as irritable bowel syndrome. What is the reason and how is the treatment performed? Let's figure it out.

Unfortunately, the etiology and methods of treatment of IBS cause more questions than answers. Physicians are well aware of the main symptoms, but the causes that cause the syndrome, sometimes remain unexplained.

Features of IBS

The main symptoms of IBS are pain and discomfort in the abdomen, which decrease after visiting the toilet. Diseases are very common, it affects more than 20% of the total population of developed countries.

In this case, the syndrome is more common in women than in men. As for Russia, here the prevalence of IBS is about 10-15%. The main somatic symptoms include diarrhea, intestinal pain and constipation, neurotic symptoms such as panic, phobias, and various stresses are often identified.

As a rule, irritable bowel syndrome occurs after eating, which causes the stomach to swell. This reaction occurs on the intake of certain drugs, with alcohol, coffee and chocolate. In addition, this is a pronounced sign of PMS.

Unambiguous reasons for the appearance of IBS have not yet been identified. Nevertheless, the latest research shows that the disease is closely related to inflammation in the intestines and various infectious diseases, including acute bacterial gastroenteritis.

Why is the sensitivity threshold in the presence of this syndrome reduced? Most likely, it is caused by the psychological state of the patient, because the functions of the psyche and the gastrointestinal tract are sufficiently related. As a result, patients describe their condition more emotionally than just aggravate it.

Irritable Bowel Syndrome

Irritable bowel syndrome is a disorder of the gastrointestinal tract, in which there are pains in the abdomen, diarrhea, constipation, bloating or spasms caused by a violation in the transmission of signals from the brain to the intestine. In irritable bowel syndrome, symptoms and manifestations of the disease can change every day, then for the better, then for the worse.

It is noteworthy that IBS does not cause more serious diseases, such as cancer or inflammatory bowel disease.

What is the cause of irritable bowel syndromes?

Unfortunately, at present the cause of IBS is not clear. It is believed that irritable bowel syndrome is associated with a problem where signals from the brain to the intestine are transmitted with interruptions. Such signals strongly affect the motor activity of the intestine.

Sometimes the cause of IBS can be stress, poor nutrition, hormonal changes in the body, as well as the abuse of certain antibiotics.

Symptoms of irritable bowel syndrome

The main symptoms of IBS are abdominal pain accompanied by diarrhea or constipation. There are also general symptoms of bowel irritation syndrome, such as bloating, mucus discharge in the stool, unpleasant feeling of incomplete bowel movement.

Quite often, patients with irritable bowel syndrome suffer from diarrhea or constipation. As a rule, one of the symptoms usually prevails and manifests itself more often than others.

IBS is a fairly common disease. However, in most patients, his symptoms are so vague that people simply do not consult a doctor. Although sometimes the symptoms can be very serious.

How is IBS diagnosed?

As a rule, the diagnosis of IBS is made by the doctor on the basis of the symptoms manifested in the patient. The doctor will ask you to tell about your state of health before the illness, about the signs of the disease and will conduct a medical examination. Sometimes it may be necessary to take tests of feces and sigmoidoscopy.

Treatment of irritable bowel syndrome is a very long process, however, alleviating its symptoms is a feasible task. Usually, treatment involves not so much medication as making some changes to the lifestyle and nutrition of the patient.

From the diet, it is necessary first to exclude those foods that cause an exacerbation of the disease. The patient should begin to lead a more active lifestyle and learn to control his body in various stressful situations.

How to live with irritable bowel syndrome (IBS)? - Page 1

Sex - Male. The city is Kazan. Diagnosis - Chronic cholecystitis, chronic pancreatitis Administrator

Irritable Bowel Syndrome (IBS) is a chronic disease that manifests itself in abdominal pain and changes in bowel habits. When partially digested food moves from the stomach to the intestine, the bowel contracts when food is moved. Defecation in IBS is irregular, as a result of the fact that food moves faster and slower in the digestive system. When food moves too fast, the intestine does not have enough time to remove excess water, which leads to diarrhea. In addition, if the food moves slowly, the intestine removes too much water, which leads to constipation.

How to live? Well, as it should be. I

How to live? Well, as it should be. I try to live like this:




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