Irritable Bowel Syndrome (IBS)
This is one of the most common conditions affecting the gut. Patients usually complain of recurrent abdominal pain which may vary in site and severity and is often associated with variable stool form and frequency. It is a functional condition and not a disease; the former implies that the symptoms are absolutely genuine but are not due to an identifiable disease process or detectable abnormality on investigation.
Studies suggest that IBS is much more common in women. The symptoms may follow an infection (post-infective IBS) and are often worse at times of stress.
Physical examination, stool culture and blood test results are always normal in IBS; if an abnormality is detected then the diagnosis should be re-considered.
Treatment is difficult but usually involves treating the predominant symptom. For example, if diarrhoea is the main problem then loperamide may be tried. Treating pain and bloating may be more challenging but certain patients respond to drugs affecting the levels of serotonin, such as citalopram.