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The importance of getting an IBS diagnosis
Irritable bowel syndrome (IBS) affects around 15% of the population, however, most people with IBS have never received a formal diagnosis. Many people self-diagnose IBS if they experience constipation, diarrhoea, bloating, or stomach pain. In this blog we are going to discuss why getting a formal IBS diagnosis is so important and how to go about it.
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I want to acknowledge that self-diagnosis of IBS may occur in people who are unable to access affordable health care. However, it is important to bring awareness to the fact that IBS can mask more serious and life-threatening health conditions. Where possible, a medical diagnosis should be sought.
What is IBS?
IBS is a lifelong condition and is defined as a disorder of the gut brain interaction. Our brain and gut communicate through a system of nerves and chemical signals. When this communication is disrupted, digestive symptoms such as pain, bloating, and altered bowel motions occur.
These symptoms cause great discomfort and disrupt everyday life such as work, exercise, and socialising. Thankfully IBS can be well managed through diet, lifestyle changes, psychological support, and medication. Getting a formal diagnosis is an important first step in the process.
When should I see a doctor about IBS?
We all experience stomach pain and difficulty going to the toilet every now and again. Maybe you ate something that didn’t agree with you or you feel a little blocked up while travelling. This is completely normal.
However, if you are consistently experiencing uncomfortable digestive symptoms, this is a sign that something else could be at play.
Common symptoms of IBS
- Abdominal pain or cramping.
- A change in the frequency of bowel motions (increase or decrease)
- A change in the consistency of your bowel motions.
- Feeling bloated
- Gassiness
- A sense of urgency with your bowel motions.
- Feeling like you have had an incomplete bowel motion.
Other symptoms of IBS
IBS can also impact your mental health and wellbeing. It is important to discuss these symptoms with your doctor also to ensure you get the best care.
- Anxiety about leaving the house.
- Poor body image.
- Stress around eating and concern food will trigger symptoms.
- Reduced ability to socialise, work, or exercise due to symptoms.
It can be helpful to keep a symptom diary before speaking with your doctor. This is a record of all the symptoms you experience and how often they occur.
How is IBS diagnosed?
Only a general practitioner (GP) or gastroenterologist can diagnose IBS. Dietitians can only screen for IBS and refer on for further investigations. There is no single test that can diagnose IBS, it is diagnosed by eliminating other conditions.
Your doctor will ask a series of questions around your symptoms, medical history, and family history. They will then do any required tests such as blood tests or scopes to assess for conditions such as coeliac disease, inflammatory bowel disease, or cancer.
Once other conditions have been excluded, IBS is diagnosed using the Rome IV criteria. Under this criteria, you must have abdominal pain for at least 4 days per month in the previous 2 months alongside one or more of the following:
- pain related to defecation
- a change in the frequency of bowel motions
- a change in the appearance of your stool
Tests that cannot diagnose IBS
There are many ‘gut health’ tests that you can access online which promise to diagnose digestive conditions. These include stool microbiome tests, hydrogen breath tests, or IgG food intolerance kits.
These tests are not validated and are unable to provide a diagnosis. They are a waste of money and can result in a delayed diagnosis. These tests are also unable to recognise red flags for other conditions such as endometriosis, cancer, diverticular disease, or nutrient deficiencies.
Always speak with your doctor before purchasing these tests.
The importance of excluding other diagnoses.
The symptoms of IBS overlap with many other health conditions (see the image below). Getting the correct diagnosis ensures you are effectively managing the correct health condition. Basing your diagnosis off symptoms alone is inaccurate and can harm your health.
Red flag symptoms
Some IBS symptoms are called ‘red flags’ as they can indicate a serious health concern. Even if you already have an IBS diagnosis, the occurrence of these symptoms should be investigated further with your doctor.
Red flag symptoms include:
- Unexplained weight loss
- Age of symptom onset >50 years
- Rectal bleeding or anaemia
- Fever
- Frequent vomiting
- Bowel motions overnight
- Persistent daily diarrhoea
- Family history or bowel disease or cancer
- Symptoms getting progressively worse
I have IBS. What next?
Once you have an IBS diagnosis, you can work on a treatment management plan. There are a number of options for managing IBS including working with a dietitian to make helpful dietary changes. While medical professionals are imperative in the diagnosis of IBS, dietitians are the experts when it comes to nutrition and IBS management.
If you are interested in working with a dietitian, you can find out more here.
About
Kim Lindsay, APD
Kim Lindsay is an accredited practicing dietitian and credentialed eating disorder clinician.
She provides online dietitian appointments for people who want to improve their health while developing a positive relationship with food. Kim has a special interest in disordered eating, chronic dieting, and digestive health.
