Diagnosing IBS
In the “old days” IBS used to be called a "diagnosis of exclusion” - i.e. what is left behind when every other condition has been ruled-out. Nowadays, it is very much a “positive” diagnosis because we know a lot more about it and more importantly, we know how to treat it.
Because many things can cause bowel upset, bloating or tummy pain and because there is no definite test for IBS, it is important to be careful about getting the diagnosis right.
Three things have to come together to give us this diagnosis of "IBS":
1. The symptoms (whether diarrhoea, constipation, bloating, pain....) have to be going on for at least six months (but, not necessarily every day or week; things can fluctuate a lot).
2. Your doctor or nurse must take a full story ("Medical History") and do an examination.
3. Tests to check for specific conditions including bowel inflammation and gluten “allergy” (coeliac disease) must be done and be
negative.
If these things haven’t been done, then you CANNOT call it IBS!
Check that the "key" questions have been asked
This is not an exhaustive list but should give you some direction. You will have answered some of these questions already, but check through them to ensure that all the right ones have been asked.
We need to be realistic about symptom details. The symptoms of IBS can change with time and it can be like trying to pin down a shadow. So, just look at things over the past few weeks or couple of months:
Because many things can cause bowel upset, bloating or tummy pain and because there is no definite test for IBS, it is important to be careful about getting the diagnosis right.
Three things have to come together to give us this diagnosis of "IBS":
1. The symptoms (whether diarrhoea, constipation, bloating, pain....) have to be going on for at least six months (but, not necessarily every day or week; things can fluctuate a lot).
2. Your doctor or nurse must take a full story ("Medical History") and do an examination.
3. Tests to check for specific conditions including bowel inflammation and gluten “allergy” (coeliac disease) must be done and be
negative.
If these things haven’t been done, then you CANNOT call it IBS!
Check that the "key" questions have been asked
This is not an exhaustive list but should give you some direction. You will have answered some of these questions already, but check through them to ensure that all the right ones have been asked.
We need to be realistic about symptom details. The symptoms of IBS can change with time and it can be like trying to pin down a shadow. So, just look at things over the past few weeks or couple of months:
- How long has the problem been going on for? Anything like this in the past?
- What is the main or key symptom (diarrhoea, constipation, constipation AND diarrhoea)?
- If constipation, is there any straining on using the toilet? Feel a lump "coming down"? Feel not quite empty? Just never have any urge to go to the loo? Need to use a finger to help things come out?
- Are there any added gut symptoms (pain / discomfort, bloating, passing gas, mucus / jelly in stool)?
- Was there a definite starting point (food poisoning, overseas trip, giving birth, course of antibiotics, a recent illness)?
- What is your medical history (previous operations, conditions)?
- Is there a family history of particular bowel conditions or cancer (bowel / ovary)?
- What medications or supplements etc are you taking?
- Has your doctor or nurse performed a physical examination?
