DIAGNOSIS OF IBS

How is IBS diagnosed?

If you think you have IBS, seeing your doctor is the first step. IBS is generally diagnosed on the basis of a complete medical history that includes a careful description of symptoms and a physical examination.

There is no specific test for IBS, although diagnostic tests may be performed to rule out other problems. These tests may include stool sample testing, blood tests, and x rays. Typically, a doctor will perform a sigmoidoscopy, or colonoscopy, which allows the doctor to look inside the colon. This is done by inserting a small, flexible tube with a camera on the end of it through the anus. The camera then transfers the images of your colon onto a large screen for the doctor to see better.

If your test results are negative, the doctor may diagnose IBS based on your symptoms, including how often you have had abdominal pain or discomfort during the past year, when the pain starts and stops in relation to bowel function, and how your bowel frequency and stool consistency have changed. Many doctors refer to a list of specific symptoms that must be present to make a diagnosis of IBS.

Symptoms include
· Abdominal pain or discomfort for at least 12 weeks out of the previous 12 months. These 12 weeks do not have to be consecutive.

· The abdominal pain or discomfort has two of the following three features:
It is relieved by having a bowel movement.
When it starts, there is a change in how often you have a bowel movement.
When it starts, there is a change in the form of the stool or the way it looks.

· Certain symptoms must also be present, such as
a change in frequency of bowel movements
a change in appearance of bowel movements
feelings of uncontrollable urgency to have a bowel movement
difficulty or inability to pass stool
mucus in the stool
bloating

· Bleeding, fever, weight loss, and persistent severe pain are not symptoms of IBS and may indicate other problems such as inflammation, or rarely, cancer.
The following have been associated with a worsening of IBS symptoms
large meals
bloating from gas in the colon
medicines
wheat, rye, barley, chocolate, milk products, or alcohol
drinks with caffeine, such as coffee, tea, or colas
stress, conflict, or emotional upsets
Researchers have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can worsen IBS problems.
In addition, people with IBS frequently suffer from depression and anxiety, which can worsen symptoms. Similarly, the symptoms associated with IBS can cause a person to feel depressed and anxious.
What is the treatment for IBS?
Unfortunately, many people suffer from IBS for a long time before seeking medical treatment. Up to 70 percent of people suffering from IBS are not receiving medical care for their symptoms. No cure has been found for IBS, but many options are available to treat the symptoms. Your doctor will give you the best treatments for your particular symptoms and encourage you to manage stress and make changes to your diet.
Medications are an important part of relieving symptoms. Your doctor may suggest fiber supplements or laxatives for constipation or medicines to decrease diarrhea, such as Lomotil or loperamide (Imodium). An antispasmodic is commonly prescribed, which helps to control colon muscle spasms and reduce abdominal pain. Antidepressants may relieve some symptoms. However, both antispasmodics and antidepressants can worsen constipation, so some doctors will also prescribe medications that relax muscles in the bladder and intestines, such as Donnapine and Librax. These medications contain a mild sedative, which can be habit forming, so they need to be used under the guidance of a physician.
A medication available specifically to treat IBS is alosetron hydrochloride (Lotronex). Lotronex has been reapproved with significant restrictions by the U.S. Food and Drug Administration (FDA) for women with severe IBS who have not responded to conventional therapy and whose primary symptom is diarrhea. However, even in these patients, Lotronex should be used with great caution because it can have serious side effects such as severe constipation or decreased blood flow to the colon.
With any medication, even over-the-counter medications such as laxatives and fiber supplements, it is important to follow your doctor’s instructions. Some people report a worsening in abdominal bloating and gas from increased fiber intake, and laxatives can be habit forming if they are used too frequently.
Medications affect people differently, and no one medication or combination of medications will work for everyone with IBS. You will need to work with your doctor to find the best combination of medicine, diet, counseling, and support to control your symptoms.