What Should I Do if I Think I Have IBS?

Getting a diagnosis of IBS can take time, but is important if you need treatment

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If you think you have irritable bowel syndrome (IBS), the first thing you will want to do is get an accurate diagnosis. It will take time to get a diagnosis of IBS, and there may be several doctor visits as well as test involved. However, it is important to note that there are many other conditions that can cause the same symptoms as IBS, and only after getting a diagnosis can you treat the problem properly.

Following is an outline of the steps that you may take to determine the cause of your symptoms:

  • Compare symptoms with those typical of IBS
  • Keep symptom and food logs
  • Discuss logs with physician
  • See a digestive specialist (if necessary)
  • Undergo testing to determine cause of symptoms
  • Begin treatment

What IBS Is — And Isn’t

IBS is a functional disorder of the colon (large intestine) that causes crampy abdominal pain, bloating, constipation and/or diarrhea. IBS is not the occasional bout of diarrhea that resolves on its own which most adults suffer from about four times a year. Rather, IBS is a chronic condition with symptoms that do not resolve on their own, or are worsened by particular stimuli or “triggers.”

IBS is not ulcerative colitis or colitis. IBS will not lead to colon cancer nor will it cause blood in the stool. IBS is known as a functional gastrointestinal disorder because no structural or biochemical cause can be found to explain the symptoms—the colon shows no evidence of disease such as ulcers or inflammation.

Do I Need a Specialist?

Start by keeping a log of your digestive symptoms, and a food diary. Logs are more effective that memory in helping describe your symptoms to your physician. In addition, any patterns in your symptoms will become very apparent when written down on paper.

Next, bring your logs to your family physician or internist who can help you determine if you need to see a digestive system specialist—a gastroenterologist.

If you do make the decision to see a specialist, be sure to keep your regular doctor informed.

How Do I Get a Diagnosis?

A gastroenterologist will take a careful history of any IBS symptoms, as well as conduct some tests.

Rome Criteria. The Rome Criteria is a set of guidelines that outlines symptoms and applies parameters such as frequency and duration to make a diagnosis of IBS.

Diagnostic tests may also be used to rule out other possible digestive disorders and diseases such as infection, bacterial overgrowth, or colitis.

Rectal exam. During a rectal exam, the doctor inserts a lubricated, gloved finger into the rectum to feel for abnormal areas and check for bleeding.

Stool culture. A physician may want to rule out other causes for diarrhea, such as a bacterial infection or parasite, with a stool culture.

Sigmoidoscopy. During a sigmoidoscopy the doctor will examine the last one third of the large intestine, which includes the rectum and sigmoid colon, with a flexible viewing tube called a sigmoidoscope.

Colonoscopy. A colonoscopy can examine the inside of the colon beyond the areas a sigmoidoscopy can reach. This test uses a colonoscope, which is a flexible tube with lenses, a tiny TV camera and a light at the end.

Beginning Treatment

If the diagnosis is in fact IBS, your physician will help you to devise a treatment plan. Treatment may include dietary and lifestyle changes, medication, or complementary therapies.

Dietary changes. Everyone with IBS has their own specific trigger foods. Some of the more common triggers include alcohol, artificial sweeteners, artificial fat (olestra), carbonated beverages, coconut milk, coffee, dairy, egg yolks, fried foods, oils, poultry skin and dark meat, red meat, shortening, and solid chocolate.

Lifestyle changes. Stress doesn’t cause IBS, but like any medical condition, it can make it worse. Eliminating stressful situations and learning to control stress when it does occur may help. Other changes that a physician may recommend are losing weight, stopping smoking, and getting regular exercise.

Medications. There are several medications that may be used to help treat IBS symptoms. IBS drugs have different mechanisms of action, but none of them are a cure, and some people may have to try several before finding one that helps symptoms.

Complementary therapy. Complementary therapies can include anything from supplements to support groups. Some supplements that may have an effect on IBS include acidophilus, chamomile, ginger, and peppermint oil. Hypnosis has also been proven to be effective in treating IBS symptoms. Cognitive behavior therapy and biofeedback are newer treatments that helps redefine the associations between worrisome circumstances and a person’s typical reaction to them.

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