Fast Five Quiz: Do You Know Key Differences Between Irritable Bowel Syndrome and Inflammatory Bowel Disease?

Jamie Shalkow, MD; Daniel Margain, MD


July 12, 2018

In patients with IBS, fibromyalgia is a common comorbidity. Symptoms may worsen in the perimenstrual period. Stressor-related symptoms may be revealed with careful questioning (emphasize avoidance of stressors). Associations with dyspepsia, heartburn, nausea, vomiting, and sexual dysfunction (including dyspareunia and poor libido) have been noted in patients with IBS. Urinary frequency and urgency have also been associated with IBS as opposed to IBD.

Symptoms not consistent with IBS should alert the clinician to the possibility of an organic pathology. Inconsistent symptoms include:

  • Rectal bleeding (rectal bleeding may be present in patients with IBD)

  • Onset in middle or older age

  • Acute symptoms (IBS is defined by chronicity)

  • Progressive symptoms

  • Nocturnal symptoms

  • Anorexia or weight loss

  • Fever

  • Painless diarrhea

  • Steatorrhea

  • Gluten intolerance

According to Rome IV criteria, IBS is defined as recurrent abdominal pain, on average at least 1 day per week for the last 3 months, associated with two or more of the following:

  • Defecation

  • Change in stool frequency

  • Change in stool form

For more on the presentation of IBS, read here.


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