(Update 30.01.2020 by Kirsten Jackson Consultant Dietitian)
Whilst irritable bowel syndrome (IBS) is quite a common condition, the symptoms alone are not specific enough for a diagnosis to be made.
Similar symptoms can be seen in bowel cancer, allergies, Chron’s disease, ulcerative colitis, coeliac disease and small bowel bacterial overgrowth. Therefore, not having a correct diagnosis could be affecting your long term health or even be life threatening.
This guide is based on the National Institute of Clinic Excellence’s (NICE) clinical guideline for IBS management and diagnosis (1).
NICE are an independent body which produce healthcare guidance that is considered the ‘gold standard’ and all GPs will be aware of the content of these guidelines.
How To Get Diagnosed With IBS?
Firstly, if you think you have IBS then you need to see your GP or family medicine doctor ASAP.
Your doctor will start to consider IBS after they do an initial assessment, where they will ask you questions about your symptom history.
For IBS to be considered, symptoms must have been present for 6 months and include abdominal pain/discomfort, a change in bowel habits (e.g. loose stools/ constipation) and bloating.
IBS definition; “if an individual has abdominal pain or discomfort which is either improved with bowels opening or associated with a change in bowels e.g. frequency or form of stool”
The individual must also have at least 2 of the following symptoms alongside this;
- altered stool passage (straining, urgency, incomplete evacuation)
- bloating, distension, tension or hardness in their abdomen
- symptoms made worse by eating
- mucus with stools
Your doctor will also ask questions around symptoms which could indicate other more serious conditions such as unintentional weight loss, blood in stools or a history of certain cancers in the family.
These are known as ‘red flag’ indicators and would prompt the GP to investigate conditions such as bowel cancer.
Bloods tests are required in the diagnosis of IBS in order to rule out other conditions.
Tests required for an IBS diagnosis
- Inflammation – CRP
- Infection – White blood cells
- Coeliac disease – TTG
- Inflammatory bowel disease – faecal calprotectin
No other tests are required for the diagnosis of IBS where the above symptom criteria has been met and blood tests are normal.
If your symptoms don’t meet the definition, you have ‘red flags’ or abnormal blood results, the doctor will refer you to a specialist such as a gastroenterologist.
The specialist may want to do further investigations. This may include colonoscopy/ MRI/ hydrogen breath tests or an ultrasound.
Seeing a Dietitian
It is recommended that you see a dietitian after you have an official IBS diagnosis.
A dietitian will help you to pin-point your food triggers and manage your IBS long-term.
If you would like further information on this issue or to book an appointment please contact me.