Externally Peer Reviewed by Mosby General Features History. Patients often describe a long history of chronic or intermittent diarrhea, which usually starts before 50 years of age and is exacerbated by anxiety or stress.
Diarrhea is often worse in the morning and after meals.
These patients often complain of a sensation of incomplete evacuation, distension, passage of mucus, with or without associated abdominal, pelvic, and back pain. Pain is relieved by evacuation. Alternating constipation, diarrhea, and bloating is typical of irritable bowel syndrome. Diarrhea is not bloody unless accompanied by an anorectal lesion such as hemorrhoids or a fissure. There are no systemic symptoms or weight loss, and nutritional status is not compromised.