Next Steps After Receiving a Misdiagnosis of IBS
If you have been diagnosed with irritable bowel syndrome (IBS) after experiencing chronic abdominal pain accompanied by constipation and/or diarrhea, you are not alone. IBS is believed to affect 10 to 20% of adults in the United States, with a majority being women, and is in the top 10 most commonly diagnosed conditions by U.S. doctors. However, there are many other conditions that can also produce very similar symptoms. So, what should you do if you worry you have been misdiagnosed—if you’re being treated for IBS but you don’t feel better? Here are some steps to undertake with your doctor to help find an answer.
1. Understand how IBS is diagnosed.
It is important to understand how your doctor arrived at an IBS diagnosis in the first place. There isn’t one specific test to definitively diagnose IBS. Instead, your doctor will look to see if your symptoms are consistent with IBS. Your doctor will see if you meet the following criteria:
Abdominal pain at least once a week for the last three months
Pain associated with bowel movements
A change in the frequency of stool
A change in the form or consistency of stool
Symptom onset at least 6 months ago
Other common symptoms include abdominal bloating, mucus in the stool, and the feeling of incomplete bowel movements.
Your doctor will also take a medical history and perform a physical exam. Additionally, you will be screened for the presence of “red flags”, signs that you could have a more serious condition instead, such as cancer or inflammatory bowel disease (IBD). If you do have any red flags, your doctor will order additional testing to rule out these other conditions before giving you a diagnosis of IBS. However, in the absence of any of these alarm signals, the American College of Gastroenterology recommends making a diagnosis based on signs and symptoms and avoiding extensive testing.
2. Recognize red flags.
In case of an IBS misdiagnosis, it is possible that a red flag was missed or that something has changed. For this reason, it’s helpful if you can recognize red flags and notify your doctor immediately. Things to watch for include:
Nausea and vomiting
Abdominal pain or diarrhea in the middle of the night
Progressively worsening symptoms
No response to current treatment
3. Track your symptoms.
When trying to get to the bottom of your true diagnosis, one of the best things you can do is keep a running log of your symptoms. Pay attention, of course, to your symptoms, but also consider:
When the symptoms occur
How often they occur
How long they last
What you were doing (or eating/drinking) prior to their onset
If the symptoms are new or changing
This provides a more complete picture for your doctor and may help guide decisions for future testing. And the small details matter! For example, abdominal bloating can be seen with both IBS and ovarian cancer. However, with IBS, bloating tends to come and go; yet with ovarian cancer the bloating may be more consistent and get worse over time.
4. Seek additional testing.
If it isn’t IBS, further diagnostic testing will be needed to determine what is causing your symptoms. Talk to your doctor about which tests may be appropriate for you:
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- Diagnosis of IBS. International Foundation for Functional Gastrointestinal Disorders. http://aboutibs.org/diagnosis-of-ibs.html
- Diagnosis of Irritable Bowel Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/diagnosis
- IBS and IBD: Two Very Different Disorders. Crohn’s & Colitis Foundation. http://www.crohnscolitisfoundation.org/resources/ibs-and-ibd-two-very.html?referrer=http://www.healthline.com/health/irritable-bowel-syndrome/ibs-or-something-else
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