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Diagnosing IBS: Discussing Symptoms with Your Doctor

Sometimes you may feel like you are the only one who has diarrhea or constipation yet millions of Americans suffer from these symptoms that make up irritable bowel syndrome or IBS. They can be difficult to talk about but relief relies on you being open with your doctor about your symptoms.

Since IBS mimics other gastrointestinal diseases, the better you understand your own symptoms, the better your chances of getting an accurate diagnosis and proper treatment. Below, Dr. Susan Lucak, an assistant professor of clinical medicine at Columbia-Presbyterian Medical Center in New York City, describes the signs and symptoms of IBS and how other possible diagnoses are eliminated. Perhaps most important, she suggests how doctors and patients can openly communicate with each other.

What is IBS?
IBS is the most common gastrointestinal (GI) disorder in the United States, with one in five Americans affected. Patients with IBS experience a cluster of GI symptoms, including abdominal pain, bloating, diarrhea and constipation. Some people mainly suffer constipation, while diarrhea is the chief problem for others; some people have alternating bouts of each.

What causes IBS?
We don't know what causes IBS but recent research points to abnormal muscle movement in the gut during digestion. Patients also have gastrointestinal hypersensitivity, which results in abdominal pain or discomfort. And even though stress does not cause IBS, it can aggravate it. Some doctors believe it has something to do with the nervous system that is located in the GI tract, sometimes called the "second brain" or the "gut brain."

How is IBS diagnosed?
A correct diagnosis requires thorough information on a patient’s history because IBS can mimic other GI disorders, such as ulcerative colitis and Crohn’s disease – two disorders marked by inflammation in the bowel.

Generally, patients with IBS experience periodic bouts of symptoms over many years. These symptoms tend to be the same, though they can sometimes change over time.

Why is IBS under-diagnosed?
Approximately 70 percent of people with IBS have mild symptoms and will not seek medical attention. Another 25 percent have moderate symptoms that may interfere with their day-to-day activities, while 5 percent have very severe symptoms that can become disabling.

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