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Introduction
Irritable bowel syndrome (IBS) is a clinical gastrointestinal (GI) disorder with no definitive
biochemical or structural changes, physical findings, or gold standard diagnostic tests (eg,
blood tests, x-rays) to identify its presence.3,4 Therefore, it is evaluated and diagnosed based
primarily on the nature and pattern of symptoms.3 IBS is characterized by abdominal pain
or discomfort, bloating, and constipation, diarrhea, or both in alternation.5
IBS often goes unrecognized or untreated because its impact on patients’ lives is grossly
underestimated. IBS is a medical disorder with a physiologic basis. While the pathophysiology
of IBS is complex and incompletely understood, symptoms of IBS (such as abdominal
pain/discomfort, bloating, and constipation or diarrhea) seem to be influenced by an
imbalance of chemicals in the GI tract, which may lead to altered movement of food
and waste through the digestive system, increased perception of pain in the abdominal
area, and altered movement of fluid in the digestive tract (see Appendix). Research of the
role of neurotransmitters, such as serotonin, in IBS shows promise in terms of explaining
the mechanisms of IBS and for developing therapies.6,7 Treatments targeting individual
symptoms—for example, antispasmodics, laxatives/fiber products, and antidiarrheals—were,
until recently, the only options.8 Consensus recommendations on IBS from the American
College of Gastroenterology (ACG) suggest there is little evidence to support the efficacy
of these agents for the entire IBS symptom complex.9 New medications that target
multiple symptoms of IBS recently have been approved by the Food and Drug
Administration (FDA). Their mechanism of action is linked to the pathophysiology of IBS.
Current understanding of IBS and its treatment options and management recommendations
is a critical aspect of caring for IBS patients, and these topics are widely addressed in
various publications. The majority of published medical articles on IBS tend to focus on
diarrhea as the more prevalent and disabling form of IBS. Yet IBS with constipation, diarrhea,
or constipation and diarrhea in alternation each affect about one third of patients. The lack
of existing literature regarding IBS with constipation is one important reason why some
sections of this report emphasize that subtype.
The purpose of this report is to highlight many issues facing women with IBS. It is not
intended to provide a comprehensive overview of IBS or clinical recommendations for its
management and treatment. Recent telephone surveys explored patients’ and physicians’
thoughts, feelings, and perceptions of the complex physical, quality-of-life, and economic
dimensions of IBS. These surveys also helped to uncover communication gaps that exist
between patients and physicians.
Because women are reported to suffer from IBS twice as often as men10,11 and given the need
for more balanced coverage of IBS with constipation, select sections of this report discuss the
unmet clinical needs of women suffering from IBS with constipation. The report provides a snapshot of the disorder’s impact on patients’ lives and highlights the communication gaps that complicate the diagnosis and treatment of IBS. Findings from these surveys underscore the need for further awareness and education to help close those gaps, which will allow patients to partner with the health care team in developing individualized treatment
strategies. Thus, the likelihood of a positive treatment outcome will be increased.
The Society acknowledges that additional research needs to be conducted for all subtypes of
IBS as well as for IBS in men. This report is just a first step towards a better understanding
of the issues all patients with IBS face.
This report is part of a public education campaign funded by Novartis Pharmaceuticals
Corporation. This report was prepared by ApotheCom Associates LLC, and it was reviewed
and revised by experts identified by the Society for Women’s Health Research and Novartis.
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