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IBS Diagnosis
How is IBS diagnosed?
The precise cause of irritable bowel syndrome has not been yet fully
understood, and there are no tests available that would allow a
physician to determine conclusively whether or not a patient suffers
from IBS. Therefore, irritable bowel syndrome is usually diagnosed
by ruling out other known diseases that could cause similar symptoms,
such as ulcerative colitis or colon cancer.
The IBS diagnosis may typically include the following steps:
- medical history
- physical examination
- laboratory tests
- physical examination
The physician usually starts with the analysis of the patient’s
medical history, focusing on the information regarding the nature
and onset of the symptoms and family history of certain diseases,
especially of colon cancer. If the patient reports some alarming
symptoms such as unexplained or sudden weight loss, fever, evidence
of bleeding in the digestive tract, or anemia, the physician should
order a series of additional tests to determine the cause of these
symptoms as they are not characteristic for IBS.
On physical examination IBS patients in the prevailing majority
of cases appear normal, although the intestine may seem spastic
and the abdomen sensitive or painful when examined. The commonly
ordered laboratory tests to confirm the diagnosis of IBS and exclude
other illnesses are:
- blood tests including a complete blood count, blood chemistry
panel, and a test that is used to monitor inflammatory diseases
- analysis of a stool sample to rule out bleeding in the digestive
tract
The physician may also order X-rays of the abdomen, endoscopic exams
such as endoscopy, sigmoidoscopy, or colonoscopy, or a barium test.
Usually, with IBS patients, all those tests come back negative,
which means that the patients are generally healthy aside from their
IBS symptoms. At that point the physician may diagnose IBS by comparing
the nature of the patient’s symptoms with the Symptom Criteria
for IBS established at the Rome II consensus conference of the American
Gastroenterological Association and international medical societies.
Criteria for IBS Diagnosis
A patient has to experience at least 12 weeks, which need not be
consecutive, in the preceding 12 months of abdominal discomfort
or pain that has 2 out of 3 features:
1. It is relieved after the bowel movement; and/or
2. The onset of symptoms is associated with a change in frequency
of stool; and/or
3. The onset of symptoms is associated with a change in form (appearance)
of stool.
There are certain symptoms that can support the diagnosis of IBS:
- Abnormal stool frequency (more than 3 bowel movements per
day or fewer than 3 bowel movements per week)
- Abnormal stool form (lumpy/hard or loose/watery stool)
- Abnormal stool passage (straining, urgency, or feeling of incomplete
evacuation)
- Passage of mucus
- Bloating or feeling of abdominal distention
Red Flag symptoms which are not typical of IBS and should be reported
to your doctor immediately include:
- Pain that awakens/interferes with sleep
- Diarrhea that awakens/interferes with sleep
- Blood in the stool (visible or occult)
- Unexplained or sudden weight loss
- Fever
- Abnormal physical examination
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