How to Diagnose IBS?
Everything you always wanted to know about IBS (but were afraid to ask)
How is IBS diagnosed?
Irritable Bowel Syndrome (IBS) is often diagnosed using validated tools that are dependent on symptom identification and there is no standard clinical testing or chemical biomarker that has been identified.
As a result, IBS is commonly misdiagnosed and IBS patients are sometimes at risk of being placed on incorrect treatment therapies or undergoing unnecessary surgeries.
It is therefore no surprise that IBS constitutes a huge health care burden to not only people diagnosed with the disorder but to health and government institutions alike. Costs of direct medical care excluding prescribed and over-the-counter medications have been estimated to be between $1.5 billion to $10 billion annually.
IBS Risk Factors
Some of the known risk factors are:
- a person’s genetic predisposition to the disorder,
- whether they are female or male, young or old,
- or possess comorbid conditions such as depression and anxiety or other life stressors
Having a relative with a diagnosis of IBS has been positively associated with developing the disorder at some point in a person’s lifetime and this association has been documented in about 33% of IBS patients.
IBS is also two to four times more likely to develop in women than men and prevalence is higher in patients younger than 45 years of age.
How to test for IBS?
IBS is a functional disorder, meaning there are no structural or clear measures or biological disease markers to make a diagnosis.
The condition is suspected in patients with chronic abdominal pain and altered bowel habits (constipation and/or diarrhea). A clinical diagnosis requires a symptom-based approach in addition to an evaluation which may include laboratory testing or imaging to exclude underlying conditions causing symptoms. Learn more about the symptoms and types in our first IBS blog post.
The most widely used tool for standardizing the diagnosis of IBS is called the Rome IV criteria. Patients must meet certain criteria related to onset and frequency of abdominal pain, as well as how it relates to defecation, change in stool frequency, and stool appearance.
The Manning criteria also determine the likelihood of IBS diagnosis when meeting specific features such as the onset of pain linked to more frequent bowel movements, looser stools associated with the onset of pain, pain relieved by passage of stool, and abdominal bloating, diarrhea with mucus, or sensation of incomplete evacuation.
A medical provider may recommend other tests to check for infection or structural absorption malfunctions. There are different kinds of tests to rule out other causes of symptoms. These diagnostic procedures include:
- a colonoscopy,
- upper endoscopy,
- or imaging of the abdomen and pelvis by X-ray or CT scan
Stool, breath, or blood tests may also be used when patients present with chronic diarrhea to identify a diagnosis.
Treatments: How to cure IBS?
Unfortunately, there is no cure for IBS. For most patients with mild and intermittent symptoms that do not impair quality of life, symptoms may be managed with lifestyle and dietary modification alone.
IBS does not increase a patient’s risk of malignancy; it is a chronic disease. Patients may benefit from excluding foods that increase flatulence, adhering to a low FODMAP (fermentable oligo-, di-, and monosaccharides and polyols) diet is another strategy to alleviate symptoms. Learn more on what foods to avoid for IBS in our recent blog post.
Physical activity has also been shown to improve the severity of IBS symptoms. Research is limited to complementary health approaches such as acupuncture, yoga, mediation, reflexology, or hypnotherapy for the improvement of IBS symptoms. There is some evidence suggesting its usefulness, although the research is still very uncertain.
The decision to treat patients with pharmacologic agents depends on the severity of symptoms and impact on quality of life as well as the subtype of IBS. Learn more about IBS types in our recent blog post.
Treatments for those with constipation (IBS-C) may include soluble fiber, laxatives, or prescribed medications that stimulate intestinal motility, fluid secretion, or transit.
In patients with IBS-diarrhea (IBS-D), antidiarrheal agents, anticholinergic agents, bile acid sequestrants, or agents which decrease colonic motility and secretion may be considered.
Antidepressants, pain medications, or antispasmodics are also sometimes used to treat IBS.
All therapy options should be carefully discussed and managed by a patient’s medical provider.
IBS is associated with poor quality of life or missed days from work, as well as depression or anxiety. Depression and anxiety can also exacerbate IBS symptoms. Chronic constipation or diarrhea can also increase the risk of hemorrhoids. As IBS symptoms vary in severity and subtype over time, it is important for proper condition management to maintain one’s health and avoid complications from IBS.
When to see a medical provider
See your medical provider when there is a persistent change in bowel habits or signs or symptoms of IBS. IBS may look like many other medical conditions, and some may be much more serious, such as colon cancer. Discuss your signs and symptoms, especially when there are concerning issues such as weight loss, rectal bleeding, unexplained vomiting, difficulty swallowing, night time diarrhea, and persistent pain unrelieved by passing gas or a bowel movement. The onset of new signs and symptoms after age 50 is also a red flag for additional testing, especially if there is a family history of colon cancer.
Atlantia Clinical Trials is a world-class renowned Contract Research Organisation (CRO) for delivering human clinical studies.
We are currently running IBS trials in the Chicago area! This study is investigating if a food supplement can help symptoms of IBS in those diagnosed with the condition. Learn more on how to get diagnosed in our blog post.
IBS paid clinical trials
If you are diagnosed with IBS and would like to contribute to further scientific advancement and get compensated for your time, you need to:
• Have a diagnosis of IBS
• Be experiencing symptoms of IBS
• Be aged 18 or over
• 3 in-person visits to our Chicago clinic.
• Be available for 2 telephone visits
• Consume the food supplement or a comparator with no effect daily for 12 weeks
• You will need to fill out a daily short IBS symptom questionnaire