Irritable Bowel Syndrome: Medical History

Medical history (history of illness) represents an important component in the diagnosis of irritable bowel syndrome (IBS).

Family history

  • Are there frequent gastrointestinal diseases in your family (inflammatory bowel disease; colon cancer)?

Social history

  • Is there any evidence of psychosocial stress or strain due to.
    • Of your occupation?
    • Of your family situation?

Current medical history/systemic history (somatic and psychological complaints).

  • Do you suffer from pain in the lower abdomen* ?
  • When does this pain* occur?
  • Have you noticed any changes in bowel movements* (alternating between diarrhea and constipation)?
  • Do you have to push hard during bowel movements? (defecation disorder)
  • Do you suffer from flatulence* ?
  • How long have these symptoms been present?
  • Where does the pain change, or increase?
    • Food?
    • Shift work?
    • Psychological stressors?
    • Medication?
  • What other medical conditions do you have?

Vegetative anamnesis including nutritional anamnesis.

  • Do you eat a balanced diet?

Self history incl. medication history

  • Pre-existing conditions (gastrointestinal diseases; food intolerances).
  • Operations
  • Allergies
  • Medication history

* Keeping a symptom diary, if necessary, also a stool log, is useful in this complaint pattern!Targeted avoidance of, for example, fat, carbohydrates (eg FODMAPs), legumes, cereals, salicylates, onions and alcohol, can lead to the elimination or significant improvement of the complaint pattern.

Warning signs of somatic causes of disease

The following symptoms require further diagnosis to rule out somatic disease:

  • Leading symptom diarrhea (diarrhea).
  • Blood in the stool
  • Fever
  • Weight loss > 10% with unchanged food intake.
  • Nocturnal complaints
  • Waking disorders (in children)
  • Pain away from the navel (in children).
  • Menstrual disorders; pubertas tarda (delayed, incomplete or complete lack of pubertal development in boys older than 16 or girls older than 15 years).
  • Performance kink
  • Palpable resistances
  • First manifestation after the age of 50.
  • Short history (< 6-12 months) and/or progressive (advancing) symptomatology.
  • Colon carcinoma (colorectal cancer) in the family.
  • Inflammatory bowel disease in the family
  • In the basic laboratory: anemia (anemia) and signs of inflammation.