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IBS (Irritable Bowel Syndrome) in India – Epidemiological and clinical features and diagnostic criteria

The patients with IBS constitute a majority of OPD consultations across all specialities. The manifestations of IBS are different in India as compared to what is written in the textbook and our patients often have a lot of extra-intestinal symptoms also.

A task force of the Indian Society of Gastroenterology for IBS as made and conducted a nationwide survey to address the issues of Indian patients. Their findings are summarised below.

A total of 2785 patients were surveyed. The mean age of IBS patients was 39 years and 68% of them were men. IBS is typically a condition affecting young to middle aged population. The prevalence of IBS is 4.2% in the community.

GI symptoms:

Discomfort in lower abdomen 70%
Mucus with stools 54%
Diarrhea 47%
Upper abdo pain or discomfort 49%
Lower abdominal fullness 70%
Constipation 53%
Incomplete evacuation77%
Milk intolerance32%

Extra- intestinal features:

Tiredness 67%
Headache 46%
Backache 46%
Urinary difficulty 17%
Sexual  difficulty 9%
Unhappy family life 18%
Unhappy with income 27%
Unhappy with jobs 24%
Anxiety or depressed mood 60%
Sleep disturbance 39%

Diagnosis

ROME-4 criteriaManning criteria
Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with 2 or more of the following criteria:1. Related to defecation2. Associated with a change in frequency of stool3. Associated with a change in form (appearance) of stool
* Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis.
Any four of the following should be present (a) Abdominal pain that is relieved with a bowel movement, (b) Pain associated with looser stools, (c) Pain associated with more frequent stools, (d) Sensation of incomplete evacuation, (e) Passage of mucus, and (f) Abdominal distention

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