Do I Have IBS?
"I'm bloated all the time. I'm so bloated I look pregnant."
"I get pain every time I eat. Any food!"
"I always have diarrhea."
"I poop maybe once a week."
"Do I have IBS?!"
Above is just a short sample of common phrases I hear from new patients. The list goes on and on and on. Digestion is a huge part of our every day lives since we love to EAT every day (to live, ya know, it's kind of a big deal). Having pain after each or many meals is extremely frustrating.
Irritable Bowel Syndrome, or IBS for short, is a collection of symptoms. There's no blood test or lab work that can point to a single marker and say 'Ah ha! This one right here means you have IBS. Case Solved.' It's a diagnosis of exclusion - all other lab work was normal and you still have symptoms so you're stuck with this label that really leaves you with more questions than answers. The diagnosis IBS doesn't tell you how to improve your symptoms or quality of life.
Diagnostic Criteria for IBS:
Rome criteria. These criteria include abdominal pain and discomfort lasting on average at least one day a week in the last three months, associated with at least two of these factors: Pain and discomfort are related to defecation, the frequency of defecation is altered, or stool consistency is altered.
Manning criteria. These criteria focus on pain relieved by passing stool and on having incomplete bowel movements, mucus in the stool and changes in stool consistency. The more symptoms you have, the greater the likelihood of IBS.
Type of IBS. For the purpose of treatment, IBS can be divided into three types, based on your symptoms: constipation-predominant, diarrhea-predominant or mixed. (source)
Basically, you have abdominal pain, diarrhea AND/OR constipation, and it can hurt when you poop. It's kind of a general label!
When a new patient tells me that they've been diagnosed with IBS I say "Great. Let's see what labs have been run and tell me about your symptoms so we can get to the root cause."
I see many different causes of digestive dysregulation; ranging from
food intolerances or 'sensitivities'
dysbiosis (an imbalance of helpful and harmful bacteria in the colon)
anxiety and stress
reduced digestive enzymes
H. Pylori infection
to name a few. I have access to a different set of tool than a family doctor which lets me look at things like IBS from a different angle. When we can figure out the cause, we can work on getting rid of the symptoms!
So to answer the question, "Do I Have IBS?", I would say "You have problems with digestion. Let's find out why."