Irritable bowel syndrome. (Women's Health Adviser).

Irritable bowel syndrome affects an estimated 10%-15% of Americans. Although IBS can't be traced to a single, organic cause and isn't associated with life-threatening conditions or complications, the syndrome can wreak havoc in the lives of those who suffer from it.

Diagnosis. Diagnosing IBS is a matter of excluding any organic illness that can cause the same symptoms of abdominal pain, bloating, constipation, diarrhea, or alternating constipation and diarrhea. Until recently, this used to mean ordering a battery of lower GI studies. In 2002, the American College of Gastroenterology published new evidence-based IBS management guidelines, which no longer recommend routine use of these tests.

Patients who seek help for IBS symptoms are no more likely than the general population to have an organic bowel disease, so a thorough physical and history is usually sufficient in patients without any of the following warning symptoms: fever; hematochezia; weight loss greater than 10 pounds; anemia; and chronic, severe diarrhea.

However, IBS patients do have a slightly elevated risk of celiac sprue (5% vs. 1% of the general population), so routine testing for this condition can be considered. Also, routine screening for colon cancer is recommended in those over age 50 years and those with a family history of colon cancer.

In general, IBS can be diagnosed by the following criteria:

* Abdominal pain or discomfort for at least 12 weeks out of the past 12 months. The symptomatic weeks don't have to be consecutive.

* The pain has two of the following features: It's relieved by a bowel movement, accompanied by a change in the stool form, or accompanied by a change in the frequency of bowel movements.