The primary symptoms of IBS are abdominal pain or discomfort in association with frequent diarrhea or constipation and a change in bowel habits.[17] Symptoms usually are experienced as acute attacks that subside within one day, but recurrent attacks are likely.[18] There may also be urgency for bowel movements, a feeling of incomplete evacuation (tenesmus), bloating, or abdominal distension.[19] In some cases, the symptoms are relieved by bowel movements.[14] People with IBS, more commonly than others, have gastroesophageal reflux, symptoms relating to the genitourinary system, chronic fatigue syndrome, fibromyalgia, headache, backache, and psychiatric symptoms such as depression and anxiety.[9][19] About a third of men and women who have IBS also report sexual dysfunction typically in the form of a reduction in libido.[20]