April Is Irritable Bowel Syndrome (IBS) Awareness Month

The IBS Awareness Month information kit from the International Foundation for Functional Gastrointestinal Disorders (IFFGD) offers useful information for patients and clinicians, including a discussion of appropriate tests that can help confirm a diagnosis of IBS and exclude other diseases. The IFFGD notes that:

“The medical evaluation of people with suspected IBS can be quite variable. It depends on symptom presentation, age, and overall health of the person, as well as the health care practices of the physician. The starting point of the diagnosis is a detailed history to identify the characteristic symptoms of IBS, and a physical examination. Laboratory blood and stool tests, x-rays, and endoscopic procedures (eg, colonoscopy) are used not to make the diagnosis, but to rule out other diseases of the bowel, which can present with similar symptoms. These tests are usually normal in patients with IBS. Recent studies suggest that in the absence of alarm signs few tests, if any, are needed to be certain that no other diagnosis is present in those who report symptoms compatible with IBS. However, there are several situations where additional testing should be considered, particularly in patients with mostly diarrhea or diarrhea mixed with constipation.”

The IFFGD recommends performing a colon examination, such as a colonoscopy, in patients age 50 or older who have not had one previously, “as a screening test for colon polyps and cancer and not specifically for IBS.” However, if a colonoscopy is being performed for these purposes, the IFFGD recommends performing “biopsies or very small samplings of the lining of the colon (large intestine).” These tissue samplings can determine “if microscopic colitis or mild inflammation of the colon is present. In this condition, the colon can appear normal to the naked eye, but there are changes in the tissue that can be seen under a microscope. This condition can mimic symptoms of IBS (abdominal discomfort and diarrhea) but may be treated differently than IBS.”

Physicians should also consider administering a blood test for celiac disease, which can cause malabsorption of nutrients and food, and produce symptoms similar to those seen in IBS. A positive blood test should prompt an endoscopy to examine and biopsy the small intestine to confirm the diagnosis.

Physicians may want to consider a lactose breath test in patients in whom dairy product intolerance remains a concern despite dietary changes.

Download the complete kit at the IFFGD website

The IFFGD has also created this helpful infographic for IBS Awareness Month: