There is no detectable pathological change. Painless diarrhea or constipation may also be referred to as irritable bowel. It's probable that the percentage is much higher, however, since the symptoms are mild and go untreated. Proper diagnosis and treatment are important because continued irritation of the bowel may lead to diverticulosis, ulceration of the bowel, and colectomy. About 23,000 colostomies are inserted in this country annually.
Differential diagnosis involves identifying Crohn's disease and ulcerative colitis.
Crohn's is considered to be a chronic inflammatory condition of a section of the bowel wall, while ulcerative colitis adds ulceration of the wall in addition to chronic inflammation. My point is, this is a progressive condition. Early recognition of the problem is very rewarding for the clinician as well as the patient. Medical science has long suspected that the condition is caused by infection or parasitic infestation, due to the symptoms which may include flatulence, cramping, rectal itching and diarrhea or thin, ribbon-like stools. This concept is reinforced by the fact that sulfa drugs, which inhibit bacterial growth, lessen the severity or even prevent attacks of colitis.