By Annika Wood and Sascha McMeekin (IBS Dietitian in Perth)
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects the large intestine and can cause painful and uncomfortable symptoms that can affect your quality of life. Approximately 11% of the world’s population is thought to have IBS with women under the age of 50 years being most at risk. Could you be one of these people?
What does it feel like to have IBS?
People with IBS have ongoing abdominal pain that is associated with a change their bowel habits. For example, they may experience the pain alongside looser or firmer stools, or more frequent or less frequent bowel motions. Other common symptoms of IBS are bloating and excessive wind. Symptoms of IBS can be intermittent or chronic and vary in severity over time and between individuals. These symptoms can be exacerbated by factors such as stress or what you eat.
What is not usually associated with IBS?
The following are 'red flags' that could be a sign of another medical condition: unintentional or unexplained weight loss, family history of bowel disease, fever, severe or progressive symptoms occurring, onset of symptoms at 50 years or older, vomiting, bowel motions in the night, diarrhoea that is persistent daily and/or rectal bleeding and anaemia. These symptoms require further investigation by your doctor.
So, how do you know if you have IBS?
IBS can be difficult to diagnose. Currently, there is no ‘IBS test’ to detect all forms of IBS (the IBS Smart Test can identify IBS-D). A Medical Doctor is required to carefully examine an individual’s symptoms, after ruling out other gastrointestinal diseases, before arriving at a diagnosis of IBS. Ruling out other gastrointestinal diseases often requires a lot of testing. This is important to do because the symptoms of IBS can overlap with other conditions (e.g. coeliac disease, mental health conditions such as depression or anxiety, inflammatory bowel diseases, gastrointestinal cancers, and endometriosis). So deciding that you have IBS without the necessary tests could mean that an underlying condition remains undiagnosed.
The medical tests that you need will be decided by your doctor or gastroenterologist and tailored to you. This might involve a blood test, stool sample, ultrasound, colonoscopy or gastroscopy.
Pseudo diagnoses and non-scientific investigations
Not all investigations and diagnoses are valid. Diagnoses that are given the name 'psuedo-diagnoses' are not medically recognised because they are not supported by adequate scientific research. Examples of these include candidiasis and non-coeliac gluten sensitivity. These psuedo-diagnoses can pose a risk to your health if they delay appropriate management of your IBS.
Alongside psuedo-diagnoses are non-scientific investigations. These are investigations that claim to diagnose gut issues and food intolerances but once again are not supported by enough scientific evidence for the results to be valid. The tests can be costly and time consuming and unfortunately leave people no closer to finding a solution to their IBS symptoms.
Some of the common non-scientific tests include:
Intestinal permeability tests
Faecal microbiota testing
Faecal short-chain fatty acids testing
IgG food intolerance
Hydrogen Breath Tests
Hydrogen Breath Tests are available to test for lactose intolerance, fructose intolerance and small intestinal bacterial overgrowth (SIBO). They can provide valuable information particularly with suspected SIBO (in some cases), however, they do have limitations. Here are a few:
Test protocols and the interpretation of the results can vary greatly.
The amount of lactose and fructose included in these tests is much larger than the amount that you would find in a typical diet. So a positive result does not necessarily lead to a greater understanding of what you can and can't tolerate in your diet.
So, you think you might have IBS?
Top three signs you have IBS:
1) You are getting abdominal pain on average at least one day per week.
2) The pain is associated with a change in frequency or form of your bowel motions.
3) Your symptoms have latest for at least 6 months.
Always speak to your doctor for a thorough investigation of your symptoms.
If you are seeking a solution to your IBS then you do not have to do it alone. Sascha offers a supportive and comprehensive approach to managing IBS in her 'Master Your IBS Program'. You can apply to work with her by clicking this link. Consultations available in Perth, Western Australia and virtually.