Irritable Bowel Syndrome (IBS): Symptoms

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Symptoms

An expert panel has outlined a list of symptoms common in irritable bowel syndrome (IBS). Doctors often use this list of symptoms, known as the Rome II criteria, to distinguish IBS from other intestinal problems. However, people who don't have all of these symptoms may still have IBS.

You are believed to have IBS if abdominal pain or discomfort is continuous or comes and goes for a total of at least 12 weeks during the past year, and two of the three following conditions occur:⁴

• Pain is relieved by having a bowel movement.
• The frequency of bowel movements changes.
• The stools' appearance or form changes.

The presence of any of the following symptoms supports a diagnosis of IBS. The severity of your symptoms will indicate the classification of your IBS.

Bowel movement patterns

In IBS, your pattern of bowel movements varies at least 25% of the time. Two or more of the following may happen:⁵

• Bowel movements may occur either more often (diarrhea) or less often (constipation) than usual, such as having more than 3 bowel movements a day or less than 3 per week.
• Bowel movements may differ in size or consistency (may be hard and pelletlike, pencil-thin, or loose and watery).
• The way stools pass changes. You may strain, feel an urgent need to have a bowel movement, or feel that you haven't completely passed a stool.
• You may have bloating or a feeling of gas in the intestines.

Other intestinal symptoms

Some people may have lower abdominal pain with constipation that is sometimes followed by diarrhea. Other people have pain and mild constipation but no diarrhea.

Symptoms that are sometimes present include intestinal gas and passage of mucus in stools.

Nongastrointestinal symptoms

You may sometimes have other symptoms that don't affect the intestines, such as:

• Anxiety or depression.
• Fatigue.
• Headache.
• Unpleasant taste in the mouth.
• Backache.
• Sleeping problems (insomnia) not caused by symptoms of IBS.
• Sexual problems, such as pain during sex or reduced sexual desire.
• Heart palpitations (feeling like the heart skips a beat or is fluttering).
• Urinary symptoms (frequent or urgent need to urinate, trouble starting the urine stream, trouble emptying the bladder).

Symptoms often occur after a meal, during stressful times, or during menstruation.

There are many other conditions with symptoms similar to IBS.

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Last updated:	June 15, 2006
Author:	Robin Parks, MS
Reviewed By:	Kathleen Romito, MD - Family Medicine, Arvydas D. Vanagunas, MD - Gastroenterology
Editors:	Kathleen M. Ariss, MS, Pat Truman