الفهرس 
Epidemiology of IBSOnly 14 pages are availabe for public view
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Abstract
The present study aimed to study the value of colonoscopy in clinically diagnosed IBS patients to find out if there is underlying lesions and missed diagnosed cases. To fulfill this aim, we recruited fifty patients, twenty patients of them with symptoms suggestive of IBS, according to Rome criteria III, followed recovery from gastroenteritis, and thirty patients with symptoms suggestive of IBS, according to Rome criteria III, but they did not follow any attack of gastroenteritis. All patients have no warning symptoms or signs.
All studied groups are subjected to full history taking, thorough clinical examination, laboratory investigations such as urine analysis, stool analysis, CBC, ESR, abdominal ultrasonography, total colonoscopy examination of the colon with biopsy taking from rectosigmoid junction or middle part of transverse colon for histopathological examination.
In the present study, we selected our patients according to Rome criteria III which involves: Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis of recurrent abdominal pain or discomfort, (discomfort means an uncomfortable sensation not described as pain),at least 3 days per month in the last 3 months associated with 2 or more of the following:
1. Improvement with defecation.
2. Onset associated with a change in frequency of stool.
3. Onset associated with a change in form (appearance) of stool.
Other symptoms that are not essential but support the diagnosis of IBS are: Altered bowel frequency (>3 bowel movements a day or <3 bowel movements a week), altered stool form (lumpy|hard or loose|watery), altered passage of stool (straining, urgency, or feeling of incomplete evacuation), passage of mucus or feeling of abdominal distention.
IBS was found to be more common in females and middle age but no significant relation was found to be with smoking habits.
IBS patients showed a significant positive family history of IBS symptoms. In our study we found that the presence of IBS symptoms following an attack of gastroenteritis in (40%) of our IBS patients.
Regarding development of IBS symptoms in relation to diet habits. A high significant relation was found between carbohydrates, fatty diets intake and the development of IBS symptoms. No significant relation was found between proteins diets intake and the development of IBS symptoms.
As regards upper GIT symptoms in IBS patients, anorexia, nausea, heartburn and epigastric burning pain were significantly higher in IBS patients but dysphagia and repeated vomiting showed no significant relation in those patients.
In our study abdominal pain , as a main symptoms for diagnosis of IBS, was mostly colicky in character (92%), below umbilicus (70%) with insignificant radiation to the back (22%).
In our study (42%) of our IBS patients were IBS-C, (30%) were IBS-D, (22%) were IBS-M and (6%) were IBS-U, 32% were diagnosed by the change in form only, 10% were diagnosed by the change in frequency only and 58% were diagnosed by the change in both form and frequency.
Regarding symptoms suggestive of IBS in our present study bloating was 100% of IBS patients, incomplete evacuation was 32%, passing of mucus per rectum was 36%, straining was 87.5% and urgency was 23.07%.
In the present study thorough clinical examination was done with special stress on mood, palpable colon, gaseous distention and peristaltic sounds. Regarding the mood of IBS patients, 30% of them were of anxious mood and 4% were of depressed mood.
Regarding abdominal examination, palpable colon (37.5%), gaseous distention (97.5%) and increased peristaltic sounds (37.5%) were significantly higher in IBS patients.
As regards investigations done for IBS patients in our study, there was no significant findings in IBS patients regarding Urine analysis (12% abnormalities), stool analysis (22% abnormalities), CBC (12% abnormalities), ESR (8% abnormalities), Abdominal Ultrasonography (16 % abnormalities).
Regarding colonoscopic examination of the IBS patients we found that 12% of the patients show increased intersegmental contractions and 10% show mild congestion.
As regards Histopathologic examination of the IBS patients we found that 8% of the patients show chronic nonspecific inflammation and 2% show bilharzial colitis.
In our present study, there was no statistical significant difference between the non post-infective and post-infective IBS patients regarding age, sex, family history of IBS, smoking, diet, symptoms, signs, investigations and histopathological examination.
from which we can conclude that, if colonoscopy is unlikely to uncover alternative diagnosis, detect clinically important incidental lesions, or reassure the patients, then there appears to be no scientific reason to routinely perform this procedure on patients clinically diagnosed IBS. Finally, it is worthwhile to conclude that there is no valuable role for colonoscopy if there is no alarm signs indicating underlying pathology.