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Diagnosing IBS - New Guidelines

By David McEvoy

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Published: 05Jun2008
Word count: 711
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NICE otherwise known as the National Institute for Health and Clinical Excellence, have recently released new guidelines in relation to the diagnosis of Irritable Bowel Syndrome and the treatment options for IBS.

What is IBS?

IBS is one of the most common disorders affecting the digestive tract. It can be described as a complex syndrome with a combination of symptoms which can include diarrhoea, constipation or both, along with abdominal pain and bloating. Other symptoms can include mucous in the stools, excess gas and nausea. Some of these symptoms can also be present in other disorders or conditions of the digestive tract which is why diagnosis can be problematic.

The important point about IBS is that it is not dangerous and it doesn't progress to cancer or other potentially serious conditions. However, there is no cure for IBS and living with it day after day can significantly impair quality of life. Furthermore, as treatment very much depends on the symptoms that are causing the most discomfort, there is no standard treatment plan or medication to suit everyone so finding the right approach for any one individual more or less consists of trying various options until such time that relief can be obtained.

How will IBS be diagnosed?

Up until now, obtaining a diagnosis of IBS was a time consuming process that could take several years. The reason for this was because it was conducted by a process of elimination whereby all other potential conditions had to be ruled out first. These latest guidelines are expected to speed up the process of diagnosing IBS and offer more appropriate forms of treatment that are suited to the individual. So what does this all mean if you suspect you are suffering from IBS?

The guidelines now advise doctors that a diagnosis of IBS should be considered if a patient presents with abdominal pain and discomfort, abdominal bloating, and changes in bowel movements that have existed for a period of at least six months. A positive diagnosis can be made if the abdominal discomfort and pain is relieved by performing a bowel movement, is associated with changes in bowel frequency or the consistency of the stools and is accompanied by at least two of the following symptoms:

- Straining, a sense of urgency, feeling of incomplete evacuation after performing a bowel movement
- Bloating, distended abdomen, tension or hardness (more common in women)
- Symptoms that are made worse by eating
- Mucous in the stools

In order to rule out other potential conditions that may be causing the symptoms, doctors are also advised to take blood tests involving a full blood count, erythrocyte sedimentation rate, C- Reactive Protein Levels and antibody tests for Coeliac disease.

If other more serious symptoms are present, which are not normally a feature of IBS, for example blood in the stools, weight loss, or a family history of cancer of the bowel or ovarian cancer, then these patients will referred for further investigation.

What treatment options are likely to be available?

Doctors will be expected to advise their IBS patients on their lifestyle and possible changes they can make to their lifestyle which could help alleviate their IBS symptoms. They will also offer advice on exercise and on controlling the symptoms of IBS.

As it is considered beneficial to increase the amount of fibre in the diet when suffering from IBS, many people in the past have advocated Bran. Bran is an insoluble fibre and is now discouraged. People will be advised instead to consume soluble fibre in the form of cereals like oats and supplements such as Ispaghula husk.

If diagnosed with IBS and your symptoms are causing you distress, your doctor is likely to prescribe medication based on which symptom or symptoms are the most dominant. This can include antispasmodic medication for muscle cramps and spasms, laxatives (the use of Lactulose is discouraged) for constipation, anti diarrhoeal agents for diarrhoea, and even Tricyclic anti-depressants and the newer type of anti depressants known as SSRi's or Selective Serotonin Reuptake Inhibitors for pain and for helping to promote normal bowel movements.

Do you think you have IBS?

If you suspect that you may be suffering from Irritable Bowel Syndrome then speak to your doctor for an accurate diagnosis and advice.

The author- Dave McEvoy is an award winning personal trainer with over 20 years experience; he has also suffered from IBS for 15 years. For more information please come a visit our site.

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