Diagnosis of irritable bowel syndrome People with irritable bowel syndrome (IBS) typically report that they suffer with abdominal
cramps and
constipation. In some patients, chronic constipation is interspersed with brief episodes of
diarrhoea; while a minority of patients with IBS have only diarrhoea. The presentation of symptoms is usually months or years and commonly patients consult different doctors, without great success, and doing various specialized investigations. It notices a strong correlation of the reported symptoms with
stress; indeed diarrhoeal discharges are associated with
emotional phenomena. IBS blood is present only if the disease is associated with
haemorrhoids.
faecal incontinence and the gastrointestinal complications of
HIV have used the Bristol scale as a diagnostic tool easy to use, even in research which lasted for 77 months. Historically, this scale of assessment of the faeces has been recommended by the
consensus group of
Kaiser Permanente Medical Care Program (
San Diego, California, US) for the collection of data on functional bowel disease (FBD). More recently, according to the latest revision of the
Rome III Criteria, six clinical manifestations of IBS can be identified: These four identified subtypes correlate with the consistency of the stool, which can be determined by the Bristol stool scale. The research results (see table) indicate that about 1 in 5 people have a slow transit (type 1 and 2 stools), while 1 in 12 has an accelerated transit (type 5 and 6 stools). Moreover, the nature of the stool is affected by age, sex,
body mass index, whether or not they had
cholecystectomy and possible
psychosomatic components (
somatisation); there were no effects from factors such as
smoking,
alcohol, the level of education, a history of
appendectomy or familiarity with gastrointestinal diseases, civil state, or the use of
oral contraceptives.
Therapeutic evaluation Several investigations correlate the Bristol stool scale in response to medications or therapies, in fact, in one study was also used to titrate the dose more finely than one drug (
colestyramine) in subjects with
diarrhoea and faecal incontinence. In a
randomised controlled study, the scale is used to study the response to two laxatives:
Macrogol (
polyethylene glycol) and
psyllium (
Plantago psyllium and other
species of the same
genus) of 126 male and female patients for a period of 2 weeks of treatment; failing to show the most rapid response and increased efficiency of the former over the latter. In the study, they were measured as primary
outcomes: the number weekly bowel movements, stool consistency according to the types of the
Bristol stool scale, time to defecation, the overall effectiveness, the difficulty in defecating and stool consistency.
moxicombustion, laxatives in the elderly, preparing
Ayurvedic poly-phytotherapy filed TLPL/AY, psyllium,
mesalazine,
methylnaltrexone, and
oxycodone/
naloxone, or to assess the response to physical activity in athletes. ==History==