How to distinguish irritable bowel syndrome from chronic diarrhea?
The diagnosis of irritable bowel syndrome should be based on the presence of abdominal pain that is associated with defecation and abnormal bowel habits. Chronic continuous diarrhea in the absence of pain is not irritable bowel syndrome, although it may be functional in nature. Symptom criteria (Rome III criteria) have been published for clinical and research purposes and include the presence of at least 3 days per month of abdominal pain or discomfort in the last 3 months that is associated with at least two of the following three features:
- A. Relieved by defecation.
- B. Onset associated with a change in stool frequency.
- C. Onset associated with a change in stool form or appearance. Symptom onset must be at least 6 months prior to diagnosis.