Irritable Bowel Syndrome (IBS) is a common, chronic gastrointestinal disorder. It is characterized by symptoms causing digestive discomfort. While IBS can impact daily life, it does not lead to permanent damage of the digestive system.
Recognizing Common IBS Symptoms
Persistent abdominal pain or discomfort is a primary symptom of IBS, often leading individuals to seek medical attention. This pain can manifest as cramping, a dull ache, or sharp sensations, and is frequently relieved after a bowel movement. Changes in bowel habits are also prominent, including diarrhea, constipation, or an alternation between the two.
Beyond pain and altered bowel movements, people with IBS commonly experience bloating and increased gas. These symptoms are chronic and can fluctuate in intensity, sometimes appearing as “flare-ups” triggered by certain foods or stress. Some individuals also report mucus in stool or a feeling of incomplete bowel emptying.
The Path to an IBS Diagnosis
When symptoms suggest IBS, a doctor starts with a thorough medical history. They discuss the patterns, duration, and severity of symptoms, as well as any potential triggers. A physical examination is also performed to check for tenderness or abnormalities in the abdomen.
Initial diagnostic steps often include blood tests to rule out conditions like celiac disease or inflammatory bowel disease (IBD). Stool tests may also be ordered to check for infections or the presence of blood. IBS is often a diagnosis of exclusion, meaning other conditions with similar symptoms must be ruled out first.
Formal Diagnostic Criteria
Doctors rely on specific guidelines, known as the Rome IV criteria, to diagnose IBS. These criteria require recurrent abdominal pain, occurring on average at least one day per week, over the last three months. The onset of symptoms must have been at least six months prior to the diagnosis.
The abdominal pain must be associated with two or more of the following: related to defecation, a change in stool frequency, or a change in stool form (appearance). For instance, pain that lessens after a bowel movement, or a noticeable shift from regular bowel movements to frequent diarrhea or severe constipation, would meet these criteria.
Excluding Other Conditions
Before confirming an IBS diagnosis, doctors must exclude other conditions that share similar symptoms. These include inflammatory bowel diseases like Crohn’s disease or ulcerative colitis, celiac disease, or microscopic colitis. Certain infections can also present with gastrointestinal distress resembling IBS.
This exclusionary process may involve specific tests if “red flag” symptoms are present. These symptoms include unexplained weight loss, rectal bleeding, fever, anemia, or symptoms that awaken a person from sleep. In these cases, tests like a colonoscopy, endoscopy, or specialized blood tests for inflammation or celiac antibodies may be performed to ensure an accurate diagnosis.