The following symptoms and complaints may occur together with irritable bowel syndrome (IBS):
Leading symptoms
- Recurrent (recurring) pain in the lower abdomen* .
- Altered bowel habits* such as alternating constipation (constipation) and diarrhea* * (diarrhea) (one can distinguish an obstipation-dominant type, a diarrhea-dominant type, and a mixed type)
- Attention: if diarrhea exists as a leading symptom, there is usually no irritable bowel syndrome
- Meteorism (flatulence)
* With this symptomatology, a functional bowel disorder is present in half of affected patients.* * Up to 30 bowel movements per day is not uncommon.
Symptoms are increased during episodes of stress or times of emotional upset.
Associated symptoms
- Dyspepsia (upper abdominal discomfort).
- Belching
- Heartburn
- Nausea (nausea)
- Vomiting
- Changes in stool frequency
- Difficult stool passage
- Increased urge to defecate (until: imperative defecation).
- Small-volume bowel movements
- Mucus discharge
- Feeling of incomplete bowel evacuation
- Meteorism (flatulence)
- Distensionsgefühl – feeling of overstretching in the intestine.
- Food intolerances (food intolerances).
Notice.
- The symptomatology of symptomatic uncomplicated diverticular disease shows a similarity to irritable bowel syndrome.
- Patients with gastrointestinal symptoms are more likely to report concurrent depression.
Warning signs (red flags) for somatic causes of illness
The following symptoms require further diagnosis to rule out somatic (physical) disease:
- Medical history:
- Family history of inflammatory bowel disease
- Colon carcinoma (cancer of the large intestine) in the family
- Short medical history (< 6-12 months) and/or progressive (progressing/increasing) symptoms.
- Initial manifestation (first occurrence) after the age of 50.
- In the basic laboratory: anemia (anemia) and signs of inflammation.
- Leading symptom diarrhea (diarrhea).
- Blood in the stool (hematochezia) or occult blood in the stool.
- Fatty stools (steatorrhea)
- Fever
- Weight loss > 10% with unchanged food intake.
- Performance kink
- Night discomfort or waking up due topain or symptoms.
- Nocturnal defecation
- Pain localize
- Waking disorders (in children)
- Pain away from the navel (in children).
- Palpable resistances
- Cycle disorders (menstrual disorders)
Notice:
- Although alarm symptoms have a high specificity for the presence of underlying inflammatory or malignant diseases, they still do not play a decisive role in their exclusion because of their very low sensitivity.
- If the RDS symptomatology exists only for less than 12 (to 24) months, so in particular malignant causes (tumor diseases) are also to be excluded: colorectal carcinoma (colon and rectal cancer / colon and rectal cancer) and ovarian cancer (ovarian cancer; in about 85% of affected patients occur before the cancer diagnosis typical irritable bowel symptoms new; often as the first symptom).