A source for healthcare professionals to access the latest data and information on the diagnosis, treatment and management of patients with gut related disorders


Symptoms of irritable bowel syndrome

Dr Fermín Mearin-Manrique

Director of the Department of Gastroenterology, Institute of Functional and Motor Digestive Disorders, Barcelona, Spain

Symptoms in this patient point towards a diagnosis of irritable bowel syndrome (IBS)
IBS is characterised by the presence of recurring abdominal pain linked to changes in the pattern of bowel movements, be it constipation, diarrhoea, or both.1 In accordance with the Rome IV criteria there must be pain at least one day a week, associated with two or more of the following characteristics: defecation, change in frequency of bowel movements, change in stool consistency. Additionally, the criteria must have been met for at least the past three months, and the symptoms must have begun at least six months prior to the diagnosis.1

IBS commonly overlaps with other functional bowel disorders, such as functional constipation or diarrhoea.1 In fact, in the case that the patient presents with very mild, occasional pain, which only occurs during episodes of diarrhoea their symptoms would meet more of the criteria for functional diarrhoea than for IBS. Therefore, before ruling out any possible organic causes of diarrhoea or pathophysiological mechanisms, the initial diagnosis should be diarrhoea and not IBS.1


Dr Fermín Mearin-Manrique is Director of the Department of Gastroenterology at the Teknon Medical Center, Barcelona, Spain. Doctor Cum Laude at the Autonomous University of Madrid, Dr Mearin-Manrique has experience in professional and research centre of excellence including the Mayo Clinic in the United States and the Hospital Vall d'Hebron in Barcelona. He is the ex-President of the Spanish Gastroenterology Association and the author of numerous renowned Spanish and international scientific papers, such as the Rome IV criteria.


1. Lacy B et al. Gastroenterology 2016;150:1393–1407.

Job number: JB57410GBj Date of Preparation: June 2019

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