Irritable bowel syndrome (IBS), Pt 1: Diagnosis
Intro
Irritable bowel syndrome (IBS) is a common gut health condition that I see in practice, and population studies indicate that 10-15% of people in North America and 11% of people globally have IBS. IBS has also been shown to appear more in those who were younger than 50 years old, and IBS has been shown to appear modestly higher in females with 14% of females experiencing IBS and 9% of males experiencing IBS. In this blog post, you will learn about how IBS looks like and how it is diagnosed.
Symptoms of IBS
IBS manifests as abdominal discomfort and changes to bowel habits. Some common symptoms that I see in practice in those who have been diagnosed with IBS are:
Bloat, sometimes with abdominal distention
Gas - flatulence and/or belching
Abdominal pain or discomfort with gas and bloat
Constipation - described as having 3 or less bowel movements per week
Diarrhea - described as having 3 or more loose stools per day
Abnormal stool appearance - assessed via the Bristol Scale
How IBS is diagnosed
IBS is considered as a diagnosis of exclusion, meaning that after all other possible diagnoses have been ruled out, someone can be diagnosed with IBS. Some conditions that can look like IBS and need to be ruled out are:
Celiac disease
Colorectal cancer
Diverticulosis/Diverticulitis
Drug use
Gastrointestinal infections
Hyperthyroidism/Hypothyroidism
Inflammatory bowel disease - Crohn Disease and Ulcerative Colitis
Lactose intolerance
The diagnosis of IBS after the above have been rule out is done via the Rome IV Criteria for IBS, which states:
Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria*:
Related to defecation
Associated with a change in frequency of stool
Associated with a change in form (appearance) of stool
*Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis
Given the diagnostic criteria, there can be 3 different types of IBS, depending on the dominant bowel movement symptoms that a person experiences. Those 3 types of IBS are:
IBS-D (Diarrhea): The most prevalent type, with a meta-analysis revealing that this happens in 40% of IBS cases
IBS-C (Constipation): The second-most prevalent type, occurring in 35% of those with IBS
IBS-M (Mixed diarrhea-constipation): The least-common type, happening in 23% of those with IBS
Summary & Takeaways
Today, you learned about how common IBS and the common symptoms found in those diagnosed with IBS. In addition to this, you learned that IBS is a diagnosis of exclusion and that other conditions need to be ruled out in order for someone to be diagnosed with IBS, and that IBS is diagnosed via the Rome IV criteria. So, if you think you could have IBS, make sure you work with a doctor who will be able to sieve through your current symptoms and risk factors to help identify if you have IBS or not. And, I hope that this blog post was educational so that you can speak to your doctor with confidence about IBS and your concerns.
In future posts about IBS, you will learn:
The different root causes of IBS
Testing options to identify root causes of IBS
Root-cause treatment options that a licensed naturopathic doctor may recommend
& more
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