What is IBS and How Do You Know if you Have It?
IBS is one of the most common conditions seen by GPs (or primary care physicians)…
…yet we’re not that clear on exactly what it is.
If you’re considering trying anything for your gut, like probiotics, hypnotherapy or the low FODMAP diet, it’s important to go back to basics first. You need to understand exactly what IBS is and be certain that you have it. I know it sounds obvious, but so many of us hear about IBS and self-diagnose, because it ‘sounds right’ rather than taking the time to get clear on what it is and get diagnosed properly. Who can blame us, we’re busy!
So, I’ve done the work for you. It’s time to get clear.
WHAT IS IBS?
IBS is a type of functional bowel disorder (FBD). FBDs include a whole range of gastrointestinal disorders where the gut is just functioning differently to normal. This shows up in symptoms including stomach pain, bloating and a change in bowel habits.
FBDs include IBS, functional diarrhea, constipation and bloating, and opiod induced constipation. Although these are all slightly different things, there’s lots of overlap. However, IBS is by far the most common and it affects 7-15% of the population worldwide.
Irritable bowel syndrome refers to a group of symptoms coming from the bowel. There’s no disease (which is great), just a change in how the gut moves (this is called gut motility). This change in gut motility causes symptoms and changes in your poo! If motility increases, it means food moves through your system more quickly, so you’ll suffer with diarrhea. If it decreases, food will move through your system more slowly and you’ll suffer from constipation and bloating.
WHO GETS IBS?
IBS affects 7-15% of the population worldwide. However, it’s more common in:
Women (1.5 times more common than in men)
People with a lower socioeconomic status
Those under 50
WHAT ARE THE SYMPTOMS?
The symptoms normally associated with IBS are diarrhea, constipation, stomach pain, gas and bloating. However, there are also lots of less common ones like lack of energy, fatigue, back ache, bladder problems and feeling sick.
IBS is a chronic disease, meaning that it persists for a long time, or comes and goes. So, symptoms can wax and wane and the severity of symptoms can totally vary between people. As symptoms vary so much, diagnostic criteria (the Rome criteria) have been developed to classify patients depending on their sub-type.
It’s really important to get properly diagnosed with IBS by a doctor, to make sure that it’s not something more serious! I know it’s really tempting to just diagnose yourself but, because the symptoms of IBS overlap with lots of other diseases, like coeliac disease, bowel cancer and endometriosis, you need to rule these out. Getting a proper diagnosis will mean you’re totally certain about what’s causing your symptoms and you can then choose the right path for managing them.
Saying that, getting a diagnosis from a doctor isn’t always easy. I personally spent years visiting different GPs, and coming away each time with no answers. I first went to a GP when I was about 16 and I was only, finally, diagnosed, at 29! So, it will really pay off to understand the process the doctor should follow and to insist that they follow this for you.
HOW IS IT DIAGNOSED?
Unfortunately, there is no actual test for IBS, so your doctor will use your symptoms to diagnose you.
1. Firstly, they’ll do a series of tests to rule out the other diseases that I mentioned above (these may be done by your GP or with a gastroenterologist). This will normally involve a few different investigations, such as blood tests, stool tests, urine tests, and potentially a colonoscopy. I had all of these done, but the colonoscopy is only needed occasionally, and if your doctor suspects you have coeliac disease, they may do extra testing.
2. Once these more serious conditions have been ruled out, your doctor will ask you questions about your symptoms and toilet habits. They’ll use the Rome criteria to confirm that you have IBS and to classify you depending on your IBS symptom type. You’ll be classified as IBS-C (constipation predominant), IBS-D (diarrhoea predominant), IBS-M (mixed bowel habits) or IBS-U (unclassified).
An official diagnosis of IBS is made when you have the following symptoms (as per the Rome criteria), which must have started at least 6 months ago:
Recurrent stomach pain for at least 1 day per week in the last 3 months, associated with one of the following:
Related to when you poo
Change in how often you poo
Change in the form or consistency of your poo
The Rome criteria was developed due to the fact that IBS symptoms vary so much between people. These criteria then go a level further and allow you to be classified depending on your sub-type, which is incredibly helpful. This is because each sub-type has different triggers and thus different ‘tools’ which can help you with symptom management. I’ll cover this in next week’s blog post, so keep your eyes peeled.
MAKING THIS PROCESS AS EASY AS POSSIBLE
So many people suffer with IBS for years before getting properly diagnosed, so don’t let that be you. Unfortunately, so many doctors don’t take IBS seriously. I was told countless times that it was ‘all in my head.’ In order to avoid this, be really clear with your doctor on the steps above that you want them to take. Stand up for yourself and don’t take no for an answer.
I know it can be really embarrassing to talk to a doctor about your bloating and your poo. However, you really don’t need to be as they’ve heard it all (and worse) before. To make this easier, I recommend recording your food, symptoms and bowel habits for at least a week before visiting the doctor. You can then take this along to your appointment to help the doctor help you much more quickly. It’s hard to remember everything you’ve eaten and the symptoms you’ve experienced, so recording it helps make sure you’re giving the doctor an accurate picture to work with. It also avoids the embarrassment of having to talk about you poo quite so much…just hand over the food diary.
I’ve got a ready made Food + Feelings diary that you can use for this. Pop in your details below and I’ll send it over to you!
Once you've got a confirmed diagnosis of IBS, you can then start to look at ways of managing it. One thing you may want to look at is getting started on the low FODMAP diet, to help you get to the bottom of your triggers.
Thanks so much for taking the time to read this! Any questions, just let me know in the comments.