IBS Diagnosis
Irritable Bowel Syndrome: Diagnostic Procedures

IBS Diagnosis

Contents

• Choosing a Doctor
• Physical Examination
• Medical & Dietary History
• Official Rome Criteria
• Lab Tests
• Procedures

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Guide To IBS

As only about 30 percent of those with irritable bowel syndrome are receiving medical care, many people are suffering unnecessarily. If you suspect you have symptoms of IBS it is worth seeing a physician, ideally before you urgently need one. Many hospitals and medical societies can make recommendations if you do not already have a family doctor. Your doctor should be able to provide a diagnosis and suggest suitable IBS treatment options. If you are not given a treatment plan, or are not satisfied with the advice, ask your doctor to recommend a gastroenterologist. A gastroenterologist is a doctor who specializes in the digestive system. But like all specialists they prefer, even require that you come to them via a primary care physician.

How Is IBS Diagnosed?

As there is no specific test for IBS, doctors need to make an initial assessment based on a physical examination, the nature of the symptoms experienced plus a medical history. The more accurate a picture of symptoms you can give your physician the quicker and more accurate the diagnosis. For this reason it is highly recommended to keep a detailed IBS food diary for 2 to 4 weeks before your appointment. As IBS symptoms are very similar to many other conditions, the doctor will consider all options before making a diagnosis. Other conditions he may consider include:

• Lactose intolerance
• Allergies
• Peptic ulcer
• Parasite infections
• Uterine Fibroids
• Diverticular disease
• Ovarian Cancer
• Premenstrual Syndrome (PMS)
• Fibromyalgia Syndrome

(a) The Physical Examination

A routine physical exam for IBS will involve:

1.The doctor feeling the abdomen for bloating and sensitivity.
2. Using a stethoscope to listen to sounds made by the bowels. Abnormal sounds will be heard if diarrhea is present or if the person feels like they have not emptied their bowel after a movement.
3. A routine pelvic examination (in women).
4. An examination of the rectum and surrounding area.

(b) Medical & Dietary History

To determine if your symptoms meet the criteria for diagnosing IBS, your doctor may ask about:

Any recent stressful events in your life, such as moving house, divorce or problems at work. Stress appears to be a huge trigger for IBS, so if your symptoms occur more frequently when stressed, this is an indication of IBS. Read about stress and IBS.

Changes in bowel movements: How often do you pass a stool, has this frequency changed, do you regularly experience constipation or diarrhea or pass mucus?

If you experience abdominal pain, is it relieved by a bowel movement? If not, another condition may be the cause.

Do you travel a lot? Those who travel to foreign countries and drink untreated water or eat salads and fresh fruit may have been exposed to a parasitic infection which can cause similar symptoms to IBS, even prompting the condition.

What is your history of antibiotic use? Antibiotics trigger a reaction.

Do you have any food intolerances or allergies. Have you noticed any foods/drinks which trigger an attack, such as dairy, caffeine, alcohol or artificial sweeteners (sorbitol found in sugar-free chewing gum can cause problems). See IBS causes for more details.

(c) The Official Rome Criteria For Diagnosing IBS

As symptoms of IBS can vary from person to person, doctors often disagree on diagnosis. While some sufferers have daily attacks, others may experience nothing for days, weeks or even months. This naturally raises the question: when is it IBS and when it is simply an occasional bowel complaint which should be put down to, for example, stress or a virus? In response, experts from around the world have met several times in Rome to debate and agree set criteria for diagnosing IBS, among other conditions. The most important requirement for diagnosis of IBS is the presence of abdominal pain. It should also be accompanied by at least two of the following 3 symptoms: (1) Relief occurs with a bowel movement (2) Change in frequency of bowel movement and/or (3) Change in appearance of stool. This cluster of symptoms should occur for at least 12 weeks within a period of a year (not necessarily concurrently).

(d) Lab Tests

As IBS does not cause any structural 'damage' to the body, if your physical exam is normal but you are experiencing IBS symptoms, then a diagnosis of IBS may be given. However, if the physician suspects another cause, they may order other tests. Blood tests can rule out infections, inflammation, celiac disease and anemia. A fecal occult blood test (derived from a stool sample) can check for white blood cells in the stool (a sign of inflammation in the intestines which indicates irritable bowel disease, a different condition). It can also test for parasites. Usually no other tests are required. However, if symptoms occur which are not typical of IBS (such as fever, unexplained weight loss, rectal bleeding, diarrhea with blood, and pain that keeps the patient awake at night) then additional tests and procedures will probably be required.

(e) Procedures

Sometimes a sigmoidoscopy, colonoscopy or a barium enema is performed to exclude other diseases.

Sigmoidoscopy
A sigmoidoscopy requires no anesthesia; the procedure only causes mild discomfort and it takes about 15 minutes. The procedure allows a doctor to see inside the first part of the colon known as the sigmoid colon (see the human body to locate the colon). The doctor inserts a long flexible lighted tube with a camera and slowly guides it through the rectum and into the colon. The procedure is used to detect inflamed tissues, growths and ulcers. It can be used to look for early signs of cancers which may be a worry if there is unexplained weight loss, bleeding from the anus, unexplained abdominal pain and changes in bowel movements. A patient may feel slight cramping after a sigmoidoscopy.

Colonoscopy
Where a sigmoidoscopy only allows a doctor to exam the sigmoid colon, a colonoscopy allows him to view the entire colon. It is the preferred method of screening before giving a cancer diagnosis. In most cases patients are offered a light sedative and possibly pain medication. The doctor inserts a long lighted flexible tube with a camera through the rectum and slowly guides it along the colon. The tube (scope) blows carbon dioxide gas into the intestine to inflate it for easier viewing. The procedure can take up to an hour. Patients may experience some bloating or cramping after.

Barium Enema
This procedure outlines the gastrointestinal tract so that it can be examined by x-ray. The clinician inserts an enema tube through the rectum and into the colon. It is connected to a bag that contains barium sulfate. The liquid flows into the colon and acts as a contrast material, highlighting specific areas of the body. It is used to detect colon cancer, inflammatory bowel disease and other bowel disorders. Today is used slightly less often than it used to be.

For more related to Irritable Bowel Syndrome, see the following:

• IBS Natural Treatments
• IBS Diet Plan and IBS Recipes

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WOMENS HEALTH ADVICE: ABOUT IRRITABLE BOWEL SYNDROME
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