- In the United States, irritable bowel syndrome (IBS) is most common in young women.
- Rome III criteria include recurrent abdominal pain or discomfort at least 3 days per month in the last 3 months associated with two or more of the following:
- Improvement with defecation.
- Onset associated with a change in frequency of stool.
- Onset associated with a change in form (appearance) of stool.
- Criteria fulfilled for the past 3 months, with symptom onset at least 6 months prior to diagnosis.
- Rule out "red flag" symptoms before making a diagnosis of IBS.
- IBS can be mild, moderate, or severe; four different subtypes are constipation predominant, diarrhea predominant, mixed, and unsubtyped.
- The Bristol Stool Form Scale is helpful clinically in defining the spectrum of diarrhea to constipation.
IBS affects 10–20% of the adult U.S. population, is the most common diagnosis made by gastroenterologists, and is one of the top 10 reasons for visits to primary care physicians. IBS is the most common functional bowel disorder and affects predominantly women (70% of patients). This may be due to the fact that women more easily report their symptoms of abdominal pain, gas, bloating, and altered bowel movements. It may also be due to hormonal differences between men and women that may affect gut function and alter perception of pain related to abdominal distention. IBS can cause great discomfort, sometimes intermittent or continuous, for many decades in a patient's life and can have a significantly negative impact on quality of life.
The prevalence of IBS in a typical primary care practice is 12% and in a typical gastroenterology practice, 28%. The estimated total yearly cost of IBS in the United States is $21 billion. One billion dollars is spent in direct costs such as diagnostic tests, physician and emergency department visits, hospitalizations, surgeries, and medications; $20 billion is spent on intangible costs such as reduced work productivity, absenteeism, and travel to consultations. The intangible costs of IBS are human suffering and impaired quality of life. IBS sufferers incur 74% more health care costs than non-IBS sufferers.
IBS primarily affects people in the prime of their lives, mostly between the ages of 20 and 40 years. Patient surveys from both the United States and the United Kingdom report an average disease duration of 11 years, with one third of patients having symptoms for much longer. For many patients, symptoms occur frequently and significantly impair emotional, physical, and social well-being. Almost three fourths of patients report symptoms more than once a week and about half report daily symptoms. In a telephone survey of female IBS sufferers in the United States, almost 40% reported pain and discomfort as intolerable without relief. Women with IBS reported 71% more abdominal surgeries than women without IBS (58% vs 34%). The rates of gallbladder operations, hysterectomies, and appendectomies were twice as high or higher among women with IBS. Twenty-five percent had been hospitalized overnight due to symptoms. Seventy-eight percent ...