Irritable Bowel Syndrome: Frequency and Epidemiological Profile through 4530 Ileo-Colonoscopies

Abstract

Introduction: The clinical manifestations of irritable bowel syndrome are not specific. Irritable bowel syndrome (IBS) is a common condition that affects the digestive system. It is usually a lifelong problem. The diagnosis is retained after elimination of an organic cause at colonoscopy. The main objective of this study is to determine the frequency of these disorders and to study the epidemiological characteristics of these patients. Patients and Methods: From January 2016 to January 2022, were included all patients with symptoms of IBS (abdominal pain, transit disorder, abdominal bloating) referred to our department for ileocolonoscopy. Patients with warning signs (rectal bleeding, melena, anemia, altered deteroriation of the general condition) or with incomplete colonoscopy were excluded. The diagnosis of IBS was retained in patients with a normal total ileo-colonoscopy All colonoscopies were done under propofol sedation and all patients were prepared with Polyethylene Glycol (PEG). Results: Of 4530 ileo-colonoscopies performed, 1132 (25%) were indicated for symptoms of IBS without warning signs. The average age of the patients was 47 years (16-89 years), the age group of 40-65 years predominated in 41%. 66.7% were female. The frequency of symptoms was as follows: abdominal pain in 64.3% of cases, chronic diarrhea: 33%, and constipation: 30.7%, alternating diarrhea-constipation: 18.1% and abdominal bloating in 10.75%. 569 patients (50.2%) had a normal ileo-colonoscopy. Ileo-colonoscopy was abnormal in 49.8% of cases: polyps: 47%, diverticula: 19%, congestive or ulcerative colonic and/or ileal mucosa: 18.8%, tumour: 7%, lipoma: 4.7% and colonic melanosis: 3.5%. Tumors were primarily in patients > 40 years old (9%), and IBD lesions in patients < 40 years old (11%). Conclusion: Ileo-colonoscopy remains essential to eliminate an organic cause even in the presence of typical symptoms of IBS. Indeed, half of our patients with symptoms of IBS without warning signs have an organic lesion dominated by tumors primarily in those > 40 years old and IBD lesions in those < 40 years old.