Irritable bowel syndrome is one of the most common gastrointestinal diseases in Germany. The symptoms can vary from diarrhoea, flatulence and constipation to cramping pain. Unfortunately, the symptoms are rather unspecific, so that it is not possible to make a diagnosis without an exact clarification. There are different types of irritable bowel syndrome. Either diarrhoea or constipation are in the foreground, or there are mixed types between diarrhoea and constipation. Often, psychological problems also arise in the course of the disease, as the digestive problems are perceived as very stressful by those affected.

The cause for the development of irritable bowel syndrome is not known for sure, but there are indications of a disturbed interaction between the brain and the intestine (disturbed intestine-brain axis). In addition, the specific composition of the intestinal bacteria also plays a role in the development of IBS, the so-called microbiome. Often it is also an interplay of physical and psychological complaints that can lead to irritable bowel syndrome or make it worse. A careful internal-gastroenterological examination is important for the diagnosis of irritable bowel syndrome. The diagnosis is a so-called “diagnosis by exclusion”, which means that it can only be made by excluding other diseases, as there are no specific changes in the intestine or in the blood. Colonoscopy is a relevant component of irritable bowel diagnosis. Here it is imperative that step biopsies are taken, as some gastroenterological clinical pictures can cause similar symptoms.

The therapy of irritable bowel syndrome is difficult and protracted and includes some non-specific medications, which have to be tried out in a joint close care, as the same therapies are not promising for every patient and there is not always direct success in therapy.

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