from Medical topics
Published online by Cambridge University Press: 18 December 2014
Irritable bowel syndrome (IBS) is a disorder of the large bowel. There are number of diagnostic criteria for diagnosis of the condition, but the Rome criteria (Drossman, 1999) are perhaps the most often used. These state that the disorder involves three months of continuous or recurrent symptoms of abdominal pain or discomfort that is relieved by defecation and/or associated with a change in frequency of stool matter and/or associated with a change in consistency of stool. In addition, two or more of the following are present for at least three days a week: altered stool frequency; altered stool form; passage of mucous; and feelings of bloating or abdominal distension. These symptoms are relatively common, with estimates of the prevalence of IBS within the general population varying between 3 and 18%, with women being about twice as likely as men to experience IBS symptoms (e.g. Drossman et al., 1993)
Early aetiological models suggested IBS was a primary psychophysiological disorder. Latimer (1981) even suggested that its symptoms and aetiology are synonymous with those of anxiety, with symptom choice (anxiety or IBS) being determined by social learning. This strong theory is no longer tenable, and more support is given to a weaker ‘stress’ hypothesis, which suggests that IBS symptoms are multi-causal and can result from a variety of factors, including gut infection, food intolerance and stress (see ‘Psychosomatics’).
Linkages with stress
There is consistent evidence linking IBS to high levels of stress.
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