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Current Gastroenterology Reports

Erschienen in:

30.12.2023

Getting the BS out of Irritable Bowel Syndrome with Diarrhea (IBS-D): Let’s Make a Diagnosis

verfasst von: Christine L. Frissora, Lawrence R. Schiller

Erschienen in: Current Gastroenterology Reports | Ausgabe 1/2024

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Abstract

Purpose of review

Irritable bowel syndrome with diarrhea (IBS-D) is diagnosed when chronic symptoms of abdominal pain accompany loose stools, and alarm features, such as fever, anemia, rectal bleeding, and weight loss are absent. This combination of symptoms makes structural disorders, such as inflammatory bowel disease or cancer, unlikely, but does not exclude other conditions that cause these symptoms. The question is whether making a “positive diagnosis” of IBS-D based on symptoms alone and instituting therapy based on that diagnosis still makes sense.

Recent findings

Clinical observations suggest that at least two-thirds of cases of IBS-D can be explained by three mechanisms: a) food intolerances (~ 30—40%), b) bile acid diarrhea (~ 20—30%), and c) disturbed microbial flora (~ 15—20%). Other conditions that are less frequent but can cause IBS symptoms or be confused with IBS include: celiac disease, microscopic colitis, mastocytosis/mast cell activation, and drug side-effects.

Summary

Many cases of IBS-D have a discoverable, underlying cause that can direct therapy more efficiently.

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Titel: Getting the BS out of Irritable Bowel Syndrome with Diarrhea (IBS-D): Let’s Make a Diagnosis
verfasst von: Christine L. Frissora
Lawrence R. Schiller
Publikationsdatum: 30.12.2023
Verlag: Springer US
Erschienen in: Current Gastroenterology Reports / Ausgabe 1/2024
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI: https://doi.org/10.1007/s11894-023-00909-1

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