IBS: The Pathway To Diagnosis

IBS is a common health condition that affects your digestive system, causing problems with your bowel function. While its exact cause is still unknown, there are a few things that could potentially be the underlying cause.

These include:

• Food passing through your digestive system too fast or too slow

• Oversensitive nerves within your gut

• Stress and anxiety

• A family history of IBS

Defined as an incurable functional gastrointestinal disorder, having IBS effectively means that no structural or tissue problems can be identified within your digestive system.

If you are diagnosed with IBS, you will need to manage your symptoms for the rest of your life. However, there are steps you can take to help reduce them.

Symptoms of IBS

IBS is a chronic condition and it can cause a myriad of different, unpleasant symptoms.

Some of the most common symptoms of IBS are:

• Stomach pain/cramps that usually worsen after eating or feel better after emptying your bowels

• Bloating — particularly after eating certain foods, or triggers

• Diarrhoea

• Constipation

• Passing a lot of gas

• Passing mucus when trying to empty your bowels

• Nausea

• Fatigue

• A sudden urge or not being able to stop yourself from emptying your bowels (bowel incontinence)

Some days your symptoms can be worse than others, referred to as a ‘flare-up’ and often triggered by specific foods or drinks.

Some people find that avoiding their triggers reduces their symptoms, but it can take a lot of trial and error before you get to understand what your triggers are.

Types of IBS

Once you are diagnosed with IBS, there are four categories your condition can fit into:

• Constipation-dominant (IBS-C)

• Diarrhoea-dominant (IBS-D)

• Mixed IBS (you experience both constipation and diarrhoea)

• Unclassified IBS (your symptoms vary)

Knowing which type of IBS you have ensures you receive the right kind of treatment for your symptoms. For instance, medications (such as gentle laxatives) for IBS-C are not going to be useful if you have IBS-D.

There’s currently no definitive test to confirm IBS. Instead, multiple other tests are carried out to rule out other health conditions first such as Crohn's disease or coeliac disease.

A systematic approach must be taken to receive an accurate diagnosis because many symptoms of IBS can be confused with other conditions, and vice versa.

While it can take years to receive an IBS diagnosis because of this, that doesn’t mean you won’t receive any support during this time. Our team at OneWelbeck will be there for you to ensure you receive a dedicated level of care throughout your entire diagnosis journey.

There are many different steps in your IBS diagnosis journey — assessing your medical and family history, undergoing physical exams and common diagnostic tests.

Medical and family history

Discussing and assessing your medical and family history is essential when going through the IBS diagnostic process. Your family history can show how at-risk you are for certain conditions that present similar symptoms to IBS, including inflammatory bowel disease (IBD) and (rarely) bowel cancer. However, it’s important to remember that having a family history does not guarantee the development of similar conditions, but it will need to be investigated.

Your medical history will be assessed to provide insight into what could be causing your symptoms. For instance, you will be asked about your bowel habits, what symptoms you experience and how often they occur. You may also be asked if you have taken antibiotics recently or travelled abroad.

You might be requested to list the types of foods and drinks you consume regularly too. Food diaries are a good way of keeping track of what your potential triggers could be. Make a list of everything you eat and note down any symptoms you experience, as well as what time they occur. If you have a food or drink trigger, you or your doctor may notice a pattern and you can avoid that trigger moving forward.

Physical exam

A physical examination is an important part of the IBS diagnostic process. Your doctor may feel your abdomen and apply pressure to certain areas. They will check for any pain points and abnormalities within your abdomen.

A rectal exam can be a part of this process too. The purpose of this exam is to check your rectum (the lower part of your large intestine) is working properly, while also checking for any masses or sores.

You will be asked for your full consent before undergoing any physical examinations and you will be made comfortable throughout the entire process.

Common diagnostic tests

After your physical examination, you might be referred for further testing to rule out other conditions.

Common tests include:

• Blood tests — these can confirm or exclude coeliac disease, IBD and infections.

• Stool testing — this checks for IBD, parasites and the presence of blood.

• Food allergy testing — sensitivities or allergies to certain foods can be the trigger of your symptoms so it’s important to rule them out.

• Anorectal physiology testing — this is to check for dyssynergic defecation (DD) which is a muscle and nerve disorder that makes it hard for you to empty your bowels properly.

• Colonoscopy — a flexible tube with a camera attached is inserted into your rectum and provides doctors with a clear view of your colon. This test will show any swollen or irritated tissue as well as polyps or cancer.

Once other health conditions have been ruled out using the tests listed above, an IBS diagnosis may be given and a personalised treatment plan provided.

At OneWelbeck, we take a specialised approach to diagnosing IBS. Our in-house experts work across various specialities to rule out other causes for your symptoms.

We want to make the process of an IBS diagnosis easier and will always take your symptoms seriously. You deserve the highest level of care, so we will provide you with a tailored treatment plan, based on your needs and the type of IBS you have.

If you are experiencing symptoms of IBS or other digestive issues, don’t hesitate to get in touch. Our team is on hand to provide you with the support you need while undergoing the process of an IBS diagnosis.

• https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/getting-diagnosed/

• https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/

• https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/symptoms/