How to Diagnose Irritable Bowel Syndrome

Since there is no diagnostic marker associated with IBS, the diagnosis is based on symptoms and by excluding other diseases, which may have similar symptoms such as ulcerative colitis, colon cancer, diverticulosis, parasites, dysentery and other infectious illnesses. To arrive at the diagnosis of IBS positively, the doctor usually will take the following steps:

1. Thorough medical history

The doctor will take a complete medical history that includes a careful description of symptoms. The symptoms that favour diagnosis of IBS are

1. Relief of abdominal pain with defecation,

2. Looser stools with the onset of pain,

3. More frequent bowel movements at the onset of pain,

4. Abdominal bloating or distention,

5. Feelings of incomplete evacuation, and

6. Passage of mucus per rectum.

2. Physical examination

Most patients, however, will be given a thorough physical exam, which is performed mainly to rule out other medical illnesses. The patient has an overall healthy appearance. The patient may be tense or anxious. The patient may present with sigmoid tenderness or a palpable sigmoid colon.

3. Laboratory test

A stool sample will be tested for evidence of bleeding by using a special chemical test called Hemoccult slides. This is very important in the evaluation since IBS should not be associated with any bleeding. The stool will also be examined for evidence of microorganisms notorious for producing symptoms of diarrhoea or constipation.

Related:  Irritable Bowel Syndrome Causes and Glossary

Other tests may be done to rule out the deficiency of enzymes required for digestion of milk sugar or checking the level of hormones like thyroid etc.

4. X-ray

The doctor also may do diagnostic procedures such as x-rays of lower G.I. series also called a barium enema. It is a special type of X-ray that uses barium sulfate to outline the lining of the rectum and colon. Barium sulfate is a chalky chemical that shows up as white on X-ray film.

The individual is made to lie on his/her side on an x-ray table, he/she will be given an enema of barium fluid through a tube that is inserted into the rectum. You will be instructed to ‘hold’ the fluid inside while an X-ray technician will take a series of X-rays. The procedure is painless.

These studies done with x-ray helps the doctor to rule out conditions like tumour, inflammation, obstruction, and Crohn’s disease, etc.

5. Endoscopy

Endoscopy is a process of viewing the inside of the colon and its various parts through a flexible tube inserted through the anus to find out if there is a disease. These examinations are usually performed to rule out other colon disorders such as colon cancer, ulcers, inflammation and other problems, that may produce similar symptoms.

Related:  Most Common Symptoms of Irritable Bowel Syndrome

The patient is asked to lie on his left side on the exam table. Medication will be given to limit any discomfort experienced during the procedure. Then, the doctor will insert a flexible colonoscope into your rectum. This test uses a colonoscopy, which is a flexible tube with lenses, a tiny TV camera and a light at the end. Through fibre-optic technology and a video computer chip, the colonoscope can scan the inside of the colon and transmit images to a video screen.

The colonoscopy procedure can take up to 1 1/2 hours and is performed in a hospital as an outpatient procedure.

Since the mainstay of diagnosis of IBS is based on the patient’s symptoms and complaints, the medical fraternity has laid down certain criteria for positive confirmation of irritable bowel syndrome. To know more about them click here.

The Manning criteria to distinguish IBS from the organic disease are as follows:

– Onset of pain associated with more frequent bowel movements
– Onset of pain associated with looser bowel movements
– Pain relieved by defecation
– Visible abdominal bloating
– Subjective sensation of incomplete evacuation more than 25% of the time
– Mucorrhea more than 25% of the time

Recently, a consensus panel updated the Manning Criteria. The result provides a standardized diagnosis for research and clinical practice.

Related:  Irritable Bowel Syndrome Causes and Glossary

During the past three months, have you experienced continuous or recurrent symptoms of:

1. Abdominal pain or discomfort which is:
– Relieved by defecation? and/or
– Associated with a change in frequency of stool? and/or
– Associated with a change of consistency of stool?

2. Two of the following at least 25 per cent of occasions or days?
– Altered stool frequency (more than 3 bowel movements/day or fewer than 3 BMS/week)
– Altered stool form (lumpy/hard or loose/watery stools)
– Altered stool passage (straining, urgency, or feeling of incomplete evacuation)
– Passage of mucus
– Bloating or feeling of abdominal distension

Diagnosis usually is made after these symptoms have occurred for at least 3 months.

The Rome Criteria for the diagnosis of IBS require that patients must have the following continuous or recurrent symptoms for at least 3 months:

Abdominal pain or discomfort characterized by the following:

– Relieved by defecation
– Associated with a change in stool frequency
– Associated with a change in stool consistency

Two or more of the following characteristics at least 25% of the time:

– Altered stool frequency
– Altered stool form
– Altered stool passage
– Mucorrhea
– Abdominal bloating or subjective distention

Leave a Comment

Your email address will not be published.