Irritable Bowel Syndrome (IBS)


Irritable bowel syndrome is a group of functional disorders (not associated with organic damage) in the large intestine, lasting for more than 3 months, where discomfort or pain in the abdomen is associated with bowel movements or changes in normal bowel function and stool disturbances

The average prevalence of irritable bowel syndrome worldwide is about 20%, varying between 9% and 48%. The variability in prevalence rates can be explained by the fact that two-thirds of individuals experiencing symptoms of irritable bowel syndrome do not seek medical attention, and only one-third of cases seek medical assistance. The level of community and cultural awareness significantly influences the rate of seeking medical help for the disease.

In advanced countries of Europe, America, Japan, and China, the rate of seeking medical attention is high, and the prevalence of the disease reaches 30%. In countries like Thailand, it reaches 5%, while in Iran, it’s only 3.4%.

Recent epidemiological studies among Latinos, African Americans in the United States, and populations in Japan and China have shown that the prevalence of irritable bowel syndrome is not racially dependent and averages 20% across all studied categories.

The annual incidence rate of irritable bowel syndrome is 1%, with the peak incidence occurring in the young age group (30-40 years old).

The ratio of occurrence between women and men ranges from 1:1 to 2:1 according to various reports. Recent epidemiological studies have shown that irritable bowel syndrome is equally common among men in the “problematic” age group (after the age of fifty) as it is among women. The social status of both genders determines the ability to seek help due to symptoms of irritable bowel syndrome.

Disease Development and Causes:
Irritable bowel syndrome is a social disorder, and its development is based on the interaction of three pathological mechanisms:

  1. Psychosocial Influence: Reflects the impact of psychological and social factors on the development of the syndrome.
  2. Sensory-Motor Disorder: Includes disturbances in the sensitivity and activity of movement in the intestines, which can result from female diseases (causing disruptions in intestinal motility due to disorders in intestinal motility reactions), hormonal disorders such as menopause, menstrual pain, premenstrual syndrome, obesity, hypothyroidism, and diabetes.
  3. Continuous Nerve Damage: Which develops after being affected by inflammatory bowel diseases and is considered a possible cause of sensory-motor disturbances.


Neurological Manifestations:

  • Neurological symptoms are common in patients with irritable bowel syndrome. Patients often complain of headaches (resembling migraines), a sensation of lump in the throat, dissatisfaction with breathing (feeling of air shortage), and sometimes excessive painful urination.

Abdominal Pain:

  • Occurs in 50-96% of patients.
  • Typically centered around the navel or lower abdomen and varies in severity (from mild discomfort to severe abdominal cramping).
  • Pain usually diminishes or disappears after bowel movements or passing gas.
  • Primarily due to the dysregulation of intestinal motor function and increased sensitivity of intestinal wall receptors to distention. A distinctive feature is the absence of nighttime pain or other symptoms.

Bowel Disturbances:

  • Noted in 55% of patients and presents as episodes of diarrhea or constipation.
  • Diarrhea often occurs suddenly after meals, sometimes in the first half of the day.
  • Stools often contain mucus.
  • Many patients feel incomplete evacuation after defecation.
  • Urgency to defecate immediately after meals is common, especially after consuming fatty and high-calorie foods.
  • Alternating between diarrhea and constipation, with stools being firm or in the form of clumps with mucus in the morning and softer half-formed stools several times throughout the day.


  • A prominent characteristic of irritable bowel syndrome, usually worsening in the evening.
  • Bloating accelerates before defecation and decreases afterward.
  • Often localized in nature.
  • A.F. Frolovskis (1991) identified three main syndromes:
  • Splenic flexure syndrome: Common in irritable bowel syndrome cases. Due to anatomical features (its height below the diaphragm and acute angle) at the splenic flexure in patients with irritable bowel syndrome and motor disorders, favorable conditions are created for the accumulation of fecal masses and gas, leading to splenic flexure syndrome development.
    • Main manifestations include:
    • Feeling of bloating, pressure, and fullness in the upper left part of the abdomen.
    • Pain in the left side of the chest, often extending to the heart area, sometimes less in the left shoulder area.
    • Accelerated heart rate, sensation of air shortage, sometimes accompanied by a feeling of fear.
    • Appearance or exacerbation of symptoms after eating, especially if plentiful, delayed bowel movements, in cases of stress, and reduction after passing gas and defecation.
    • Abdominal bloating and noticeable distension in the left rib area.
    • Gas accumulation in the splenic flexure area of the large intestine (detected on radiography).
  • Hepatic flexure syndrome: Manifests as feelings of fullness, pressure, and pain in the lower right side below the ribs, radiating to the upper stomach, right shoulder, and right half of the chest. These symptoms mimic diseases of the biliary tract.
  • Appendix syndrome: Common and mimics the clinic of acute appendicitis. Patients complain of pain in the right iliac region, with extension to the right abdomen, gradually increasing in intensity, but usually not reaching the severity of acute appendicitis.
  • Exclusion of psychological stress factors in the external environment and treatment. In cases of fluctuations and recurrent attacks of bowel motor disorders or functional disorders of the stomach, treatment in the hospital is advised.
  • In cases of predominant constipation, follow a high-fiber diet regimen: wheat flour, oats, added to soups, loaf bread, oatmeal, grated carrots, beets; avoid spices, hot sauces, solid fats, pastry products, fresh milk, strong coffee.
  • Physical therapy and treatment with mineral waters: ion air treatment, Sherbak collar, Solux, diathermy, Electrosone, acupuncture, pine baths, Ozokerite applications.
  • In the presence of accompanying diseases (hypothyroidism, allergic colitis, bacterial imbalance disorders, menopause, etc.) – they are treated.
  • Treatment of neurological disorders and depression, including psychotherapy and sedative medications. In cases of constipation – mild laxatives, oil injections.
  • For spasms with pain – papaverine, No-Spa.
  • In case of predominant diarrhea, antidiarrheal agents are prescribed.