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Symptoms of irritable bowel syndrome
Last reviewed: 06.07.2025
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Rome III criteria (2006) focus the attention of specialists on the main clinical symptoms of irritable bowel syndrome:
- frequency of bowel movements less than 3 times a week or more than 3 times a day;
- rough and hard or soft and watery stools;
- straining during bowel movements;
- imperative urge to defecate (inability to delay bowel movement), sensation of incomplete bowel movement;
- mucus secretion during defecation;
- a feeling of fullness, bloating, or distension in the abdomen.
Like the criteria of the previous revision, Rome III criteria distinguish 3 main forms of irritable bowel syndrome: with pain and flatulence, with diarrhea or constipation. This division is convenient from a practical point of view (it helps to determine the treatment tactics), but is largely arbitrary, since half of the patients have a combination of various symptoms and the transformation of one form of irritable bowel syndrome into another (constipation changes to diarrhea and vice versa).
Abdominal pain is an obligatory element of the clinical picture of irritable bowel syndrome. It varies significantly in intensity from mild discomfort and tolerable aching pain to constant and even unbearable, simulating intestinal colic. Irritable bowel syndrome is characterized by pain immediately after eating, bloating, increased peristalsis, rumbling, diarrhea or stool frequency. The pain subsides after defecation and gas discharge, and usually does not bother at night. Pain syndrome in irritable bowel syndrome is not accompanied by weight loss, fever, anemia, or increased ESR.
Additional symptoms that help identify the variant of irritable bowel syndrome include transit and defecation disorders. A stool frequency of more than 3 times a day (diarrhea) and less than 3 times a week (constipation) is considered pathological. Irritable bowel syndrome is characterized by morning diarrhea that occurs after breakfast in the first half of the day, as well as the absence of diarrhea at night; mucus in the feces is observed in 50%.
A large number of complaints, psychopathological disorders are quite typical for patients with irritable bowel syndrome. Among the complaints, symptoms of autonomic disorders (a feeling of a lump in the throat, disturbances in the "sleep-wakefulness" rhythm, dysuria, dysmenorrhea), concomitant functional diseases of the digestive organs (dysfunction of the biliary tract and pancreas, nausea, belching, vomiting, pain in the right hypochondrium, etc.), psychopathological disorders (depression, anxiety, phobias, hysteria, panic attacks, hypochondria) dominate.
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