The Irritable Bowel Syndrome and Its Association with Unexplained Medical Symptoms and Other Functional Disorders

292 JCOM May 2006 Vol. 13, No. 5 www.turner-white.com The irritable bowel syndrome (IBS) is the best known of the functional gastrointestinal tract disorders, all characterized by chronic or recurrent gastrointestinal tract symptoms not explained by structural abnormalities, infection, or metabolic changes on routine testing [1]. Patients with IBS suffer from chronic abdominal pain, usually in the lower abdomen, with a disturbed bowel pattern. The latter can be constipation, diarrhea, or alternating constipation and diarrhea. Although the range of prevalence rates for IBS in studies conducted throughout the world is broad (2%–25%), in the Western world it is generally agreed that 10% to 20% of adults meet diagnostic criteria for IBS [2,3]. Approximately 60% to 70% of IBS patients are women [4], making it a serious women’s health concern. The burden of IBS on society is substantial. As many as 28% of referrals for gastroenterology consultations are for IBS [5]. Absenteeism rates from work or school are significantly higher among patients with IBS than healthy individuals [4]. The cost of health services for patients with IBS is very high [6,7]. Although the overall impact of IBS in terms of daily physical and emotional functioning, interpersonal relationships, and psychologic distress is probably immeasurable, disease-specific health-related quality of life instruments have been developed in an attempt to estimate its individual and societal impact [8,9]. When associated with other, nongastrointestinal, functional disorders in the same patient, the burden on health care resources and the negative impact on quality of life is often increased [10,11].