20 December 2018

5 questions to help doctors diagnose IBS

Irritable bowel syndrome remains hard to diagnose. These questions may help patients and doctors to understand the condition better.

Irritable bowel syndrome (IBS) affects many people and is often recognised through diarrhoea, constipation, abdominal cramps and other digestive issues. Medical experts don’t yet know for certain what causes it, and it’s often hard to diagnose as there can be many underlying medical conditions with the same symptoms.

However, Dr Jack Braha, a practitioner at Brooklyn Gastroenterology and Endoscopy, has five so-called “alarm” questions he asks when he suspects a patient might have IBS. These questions are based on the ROME IV diagnostic criteria for IBS, a study published to help practitioners diagnose IBS.

According to Dr Braha, the study might seem a bit “older”, but holds credibility in terms of criteria for IBS diagnosis. He shared these questions with Healio Gastroenterology and Liver Disease.

If you suspect you might have IBS, consider these five questions before you go to the doctor:

1. What is your poop like?

While many patients tend to shy away from the topic, the state of your poop can reveal a lot in the diagnosis of IBS.

“It’s just a broad, open question,” Dr Braha told Healio Gastroenterology and Liver Disease. “We ask the patient if they have loose, watery stool, if they have hard stool, or if it is hard to evacuate. It’s really important to know whether the patient feels like they had a complete evacuation, or whether it was what we call an incomplete bowel movement.”

When you go to your doctor, leave your squeamishness at home and tell them exactly what you are experiencing, whether it’s watery, mucus-laden diarrhoea or constipation. Be as specific as possible as this will give the doctor insight to what might be happening in your gut.

2. Do you experience cramps or bloating?

Dr Braha says that that if going to the bathroom brings a sense of relief to the pain and bloating, this might definitely be linked to IBS as the pain or bloating is directly linked to the bowel movement.

Try to keep a “diary” of when the pain or bloating occurs, and when you find relief, when you go to the doctor.

3. Do you tend to feel full quickly after eating?

Dr Braha states that it’s usually not a good sign when patients feel full too quickly after a meal. This signals that the digestive system can’t handle a normal amount of food and that it may even signal another problem such as colon cancer.

Give your doctor an exact description of how soon you tend to feel full when eating – does this only happen when eating certain foods and do you experience pain and bloating as well?

4. Is there blood in your poop?

While a little bit of blood when wiping might be something less serious such as an anal fissure or haemorrhoids, blood that is nestled in your stool is not good news.

Again, be as descriptive as possible – is the blood bright red or tarry? How often have you noticed this?

“Black or bloody stool is a sign of bleeding that could be anywhere in the digestive tract,” Dr Braha says. This is alarming, and could be a different medical problem, not IBS. Your doctor may refer you for a colonoscopy or endoscopy.

5. Does your need to poop wake you up at night?

Dr Braha says that those with IBS usually won’t experience diarrhoea while sleeping. If your diarrhoea is so bad that it wakes you up at night, it’s probably not IBS and could signify something else.  

Note whether you have been experiencing weight loss or anaemia along with the diarrhoea. Your doctor would also try and feel whether there is a mass or a lump in the stomach, which could signal a cancerous growth.

A condition such as food poisoning or a stomach bug that causes diarrhoea would generally only last a few days – if diarrhoea persists, it’s important to see your doctor as soon as possible.   

Image credit: iStock