Symptoms of irritable bowel syndrome
Last reviewed: 23.04.2024
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Roman criteria III (2006) emphasize specialists' attention to the main clinical symptoms of irritable bowel syndrome:
- the frequency of defecation is less than 3 times a week or more 3 times a day;
- rough and hard or soft and watery stools;
- straining during defecation;
- imperative urges for defecation (inability to delay bowel evacuation), sensation of incomplete bowel emptying;
- excretion of mucus during defecation;
- feeling of overflow, bloating or transfusion in the abdomen.
Like the criteria of the previous revision, the Roman criteria III distinguish 3 basic forms of irritable bowel syndrome: with pain and flatulence, with diarrhea or constipation. Such division is convenient from the practical point of view (it helps to determine the tactics of treatment), but is largely conditional, as in half of the patients there is a combination of various symptoms and the transformation of one form of irritable bowel syndrome into another (changing diarrhea constipation and vice versa).
Abdominal pain is an indispensable element of the clinical picture of irritable bowel syndrome. Significantly varying in intensity from mild discomfort and tolerable aching pain to a constant and even intolerable, imitating intestinal colic. Irritable bowel syndrome is characterized by the appearance of pain immediately after eating, bloating, increased peristalsis, rumbling, diarrhea, or stiffening of the stool. The pain subsides after defecation and the separation of gases, as a rule, do not disturb at night. Pain syndrome in irritable bowel syndrome is not accompanied by loss of body weight, fever, anemia. An increase in ESR.
To the auxiliary symptoms, which help to identify the variant of irritable bowel syndrome, include the violation of transit and the act of defecation. Pathological frequency of stool is considered more than 3 times a day (diarrhea) and less than 3 times per week (constipation). Irritable bowel syndrome is characterized by morning diarrhea, which occurs after breakfast in the first half of the day, as well as the absence of diarrhea at night; an admixture of mucus in stool is observed in 50%.
A large number of complaints, psychopathological disorders are quite typical for patients with irritable bowel syndrome. Among the complaints dominate the symptoms of vegetative disorders (sensation of a coma in the throat, disturbances in the rhythm of sleep-wakefulness, dysuria, dysmenorrhea), accompanying functional diseases of the digestive organs (dysfunction of the biliary tract and pancreas, nausea, eructation, vomiting, pain in the right hypochondrium, etc. .), psychopathological disorders (depression, anxiety, phobias, hysteria, panic attacks, hypochondria).