What Kind of Doctor Should I See?
If you are experiencing recurrent symptoms of abdominal pain, diarrhea and/or constipation, it is highly recommended that you make an appointment with your primary care physician. Your physician is likely to run some blood work and test for blood in the stool. In the absence of any red-flag symptoms (e.g. rectal bleeding, fever, anemia), your primary care doctor may diagnose you as having IBS without any additional testing.If your doctor believes that a more thorough investigation is necessary, you may be referred to a gastroenterologist. A gastroenterologist, commonly referred to as a GI, specializes in the diagnosis and treatment of digestive disorders. Gastroenterologists use their knowledge of the workings of the entire digestive tract and their experience in the various disorders of the gastrointestinal system to come up with a comprehensive diagnosis and treatment plan.
What Tests am I Likely to Have?
In most cases, Irritable Bowel Syndrome can be diagnosed with a minimum of diagnostic procedures:- routine blood work
- fecal occult bleeding test (a test for blood in the stool)
Are There Any Other Tests?
Should your symptom picture warrant it, your doctor might recommend one of these other common GI (gastrointestinal) procedures:- Colonoscopy: Scope of your entire large intestine. This test is routinely recommended to all individuals over the age of 50.
- Sigmoidoscopy: Examination of the rectum and the lowest part of the colon, called the sigmoid colon.
- Upper Endoscopy: Scope of your upper digestive tract, including your esophagus, stomach and duodenum.
- Barium Enema: X-ray of the large intestine with barium used for contrast.
- Upper GI Series: X-rays of the upper digestive system with barium used for contrast.
- Lactose Intolerance Testing
- Blood work to rule out celiac sprue
- Stool test to rule out intestinal parasites
How Can My Doctor be Sure it is IBS?
Physicians use a standard called the Rome III Criteria for diagnosing IBS. These criteria require that symptoms of abdominal pain or discomfort, along with a marked change in bowel habit, be present for at least six months, and that symptoms are experienced on at least three days during at least three of those six months. Two of the following conditions about the abdominal pain must be met: that it is relieved by a bowel movement, is associated with a change in the frequency of stool, and/or is associated with a change in the appearance of the stool.If all other conditions have been ruled out and the conditions of the Rome III criteria are met, your doctor can confidently diagnose you as having Irritable Bowel Syndrome.
Will I Need Surgery?
Unless diagnostic testing reveals a more serious medical condition, patients with Irritable Bowel Syndrome do NOT need to undergo any surgical procedures. Research suggests that IBS patients are at higher risk to undergo gallbladder removal, appendectomy, hysterectomy and colon surgery, without necessarily receiving significant relief from their IBS symptoms. Due to the inherent risks of surgery, it is highly recommended that the IBS patient seek a second opinion before undergoing any type of surgery.Sources:
Functional Bowel Disorders (2006) Longstreth, G.F., et.al. Gastroenterology, 130:1480-1491.
Medical Procedure Costs and Surgical Rates in Patients with Irritable Bowel Syndrome. (2007) Gamen, A. Digestive Health Matters, 16: 3-6.
