Irritable Bowel Syndrome With Constipation

Publication Date: June 21, 2022

Key Points

Key Points

  • Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction associated with worse health-related quality of life (QOL) than patients with diabetes or end-stage renal disease.
    • Its worldwide prevalence among adults is between 4.1% (Rome IV criteria) and 10.1% (Rome III criteria). IBS is most common in women and younger individuals, particularly IBS with constipation (IBS-C).
  • IBS with predominant constipation (IBS-C) is a subtype of IBS.
  • A positive diagnosis of IBS-C can be made on the basis of medical history and physical examination, evaluation of gastrointestinal symptoms (especially alarm signs), limited diagnostic testing, and use of the symptom-based Rome IV criteria.a
    • The presence of alarm features — such as new symptom onset after age 50 years; rectal bleeding not attributable to hemorrhoids or anal fissures; unintentional weight loss; iron deficiency anemia; nocturnal diarrhea; and a family history of colon cancer, inflammatory bowel disease, or celiac disease — requires more patient-specific investigations.
a Kellow JE, Drossman DA, Chang L, et al, eds. Rome IV Diagnostic Algorithms for Common GI Symptoms. 2nd ed. Rome Foundation, 2016.

Treatment

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