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How to Tell If Your Irritable Bowel Syndrome Diagnosis Is Accurate

By

Paul Milner, MD

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Around 20% of Americans have irritable bowel syndrome (IBS), a chronic intestinal disorder associated with intermittent bloating, gas, diarrhea and constipation. IBS is complex, and because other conditions that affect bowel function can give you the same symptoms, it can be very difficult to diagnose. However, doctors have identified some ways to accurately detect the disease in patients and address it properly.

Triggers Associated With IBS

IBS can be difficult to nail down because different triggers affect patients differently. The most common triggers for IBS symptoms are certain foods and high stress levels. But a food item that causes an upset stomach in one patient may not be problematic for another. If you find that your digestive health worsens during stress or in response to certain foods, these may be signs you have IBS and not another condition. Identifying triggers that cause the onset of IBS symptoms, such as constipation or diarrhea, may be enough for some patients to get an accurate diagnosis and then manage the condition. For others, an accurate diagnosis may need further investigation.

Understanding IBS Symptoms

IBS doesn’t typically lead to more serious conditions, but it can become a huge quality-of-life issue for patients. That’s why identifying the symptoms is important to get an accurate diagnosis. One way to determine if a bowel issue is related to IBS is to assess how long symptoms last and how frequently they occur. Typically, with IBS, a patient has had symptoms like abdominal pain, bloating, and discomfort for at least three days out of a month, for at least three months. Since IBS is a chronic condition, the timing of symptoms is an important factor for doctors when determining the cause of patients’ abdominal issues. And if these uncomfortable, abnormal symptoms are accompanied by changes in the stool, like constipation or diarrhea, it’s likely these symptoms will be considered IBS-related. In most IBS cases, patients feel some relief from their symptoms after defecation.

If you’re experiencing more than periodic diarrhea, constipation, cramping, bloating and gas, than you may have a more serious condition than IBS. For instance, if a patient is losing weight, has anemia, or experiences bleeding and severe inflammation in the bowel, then he or she may need to investigate other gastrointestinal conditions.

Diagnosis: Process of Elimination

Often, determining if your IBS diagnosis is accurate means ruling out other potential conditions with similar symptoms. There are several common conditions that share symptoms with IBS. Lactose intolerance, or difficulty digesting dairy products, is quite common. Some patients may have “small intestinal bacterial overgrowth,” or SIBO, where excessive bacteria can cause poor nutrient absorption and even damage the stomach lining.   

In addition to these common conditions, there are several more serious conditions that, depending on the case, I might rule out before treating a person for IBS. If a patient is older, I might consider checking for colon cancer. Inflammatory bowel diseases like Crohn’s disease, which affects the lining of the digestive tract, and ulcerative colitis, which affects the innermost lining of the intestines, are two other serious issues worth considering if gastrointestinal issues don’t improve with IBS treatment. Carcinoid syndrome is a rare condition in which a slow-growing tumor in the gastrointestinal tract (GI tract) causes a variety of symptoms, including diarrhea, so we like to rule that out in some cases, as well.

It can also be helpful to rule out celiac disease, a rare autoimmune disease associated with negative reactions to gluten, a protein found in most wheat products. Because some IBS patients feel better on a gluten-free diet even when they don’t have celiac, doctors may recommend that you cut out gluten products to ease your symptoms.

While IBS can be difficult to diagnose, there a lot of ways a physician can tailor treatment options to address your specific symptoms once the disease is recognized. Identifying the disorder is the first step toward living a healthy life with IBS. If you’re still experiencing symptoms with treatment, talk to your doctor about your concerns. Together, you can find the right way forward.



THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.


Paul Milner, MD

Paul Milner, MD, is a gastroenterologist practicing in Flowood, MS. View his Healthgrades profile >

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