Irritable bowel syndrome overview: Difference between revisions
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==Classification== | ==Classification== | ||
[[Irritable bowel syndrome|Irritable bowel syndrome (IBS)]] may be classified according to Rome IV [[Criterion|criteria]] into four sub types/groups: [[Irritable bowel syndrome|IBS]] with predominant [[constipation]] , [[Irritable bowel syndrome|IBS]] with predominant [[diarrhea]], [[Irritable bowel syndrome|IBS]] with mixed [[Bowel|bowel habits]],and [[Irritable bowel syndrome|IBS]] unclassified. In addition, [[Irritable bowel syndrome|IBS]] occurring subsequent to GI [[Infection|infections]] is known as Post [[Infection|infectious]]-IBS or PI-[[Irritable bowel syndrome|IBS]]. The rationale behind these different sub types is to maintain consistency of [[patient]] selection. This increases understanding of [[Pathophysiology|pathophysiological]] mechanisms, aids in effective [[diagnosis]], [[Treatment Planning|treatment]] and patient recruitment for [[Clinical trial|clinical trials]]. | |||
==Pathophysiology== | ==Pathophysiology== | ||
Revision as of 14:38, 27 November 2017
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Differentiating Irritable bowel syndrome from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Irritable bowel syndrome is a functional bowel disorder characterized by abdominal pain and changes in bowel habits which are not associated with any abnormalities seen on routine clinical testing. The disease is fairly common and makes up 20–50% of visits to gastroenterologists. Lower abdominal pain, and bloating associated with alteration of bowel habits and abdominal discomfort relieved with defecation are the most frequent symptoms. The abdominal pain type is usually described in a patient as either diarrhea-predominant (IBS-D), constipation-predominant (IBS-C) or IBS with alternating stool pattern (IBS-A). In some individuals, IBS may have an acute onset and develop after an infectious illness characterised by two or more of the following: fever, vomiting, acute diarrhea or positive stool culture. This post-infective syndrome has consequently been termed "post-infectious IBS" (IBS-PI) and is acute onset Rome II criteria positive. This condition is more homogeneous, being mostly IBS-D and is drawing much clinical investigation.
Chronic functional abdominal pain (CFAP) is quite similar to, but less common than IBS. CFAP can be diagnosed if there is no change in bowel habits.
Because of the name, IBS can be confused with inflammatory bowel disease (IBD).
Historical Perspective
Irritable Bowel syndrome(IBS) was first mentioned in the Rocky Mountain Medical Journal in 1950. IBS was described as a psychosomatic disorder, not explained by any biochemical or structural abnormalities. Apley and Nash conducted a famous study on 1000 children in Bristol, United Kingdom and were the first to describe Recurrent Abdominal Pain (RAP) as the predominant feature of IBS. In 1978, the first diagnostic criteria i.e. the Manning criteria was described. It did not specify any required duration for the symptoms of IBS. The subsequent criteria saw a reduction in the required duration of symptoms to facilitate early diagnosis and treatment. In Rome in 1995, an international group of gastroenterologists defined the diagnostic criteria for IBS and this was published in 1999 under the title of the Rome II criteria. This criteria underwent modification and was described as the Rome III criteria. Since June 2016, the criteria being followed is the Rome IV criteria.
Classification
Irritable bowel syndrome (IBS) may be classified according to Rome IV criteria into four sub types/groups: IBS with predominant constipation , IBS with predominant diarrhea, IBS with mixed bowel habits,and IBS unclassified. In addition, IBS occurring subsequent to GI infections is known as Post infectious-IBS or PI-IBS. The rationale behind these different sub types is to maintain consistency of patient selection. This increases understanding of pathophysiological mechanisms, aids in effective diagnosis, treatment and patient recruitment for clinical trials.