Irritable Bowel Syndrome IBS and What Tests You Should Get
Kenneth Falchukgt;gt;gt; Irritable bowel syndromeis the word points to it, is a syndrome, it is a composite of complaints that patientshave that effect the GI tract. It is not something that we could immediately say is caused byan infection or is caused by a structural change in the bowel. So therefore the physician who evaluates thepatient with irritable bowel syndrome (IBS) has to pay attention to the types of symptoms,when they occuré How frequent is your trigger factor, has to evaluate his patient for thepossibility of other conditions and that is where we bring in the criteria of or the charactersof what we call reg flags.
So irritable bowel syndrome is a combinationof symptoms that the patient mentions to the treating evaluating physician that consistsof either pain with or without a change in bowel habit such as diarrhea, constipation,or a variable pattern, a mixture of both diarrhea or constipation with bloating with a changein a shape, consistency of they stools, they could be loose, they could be hard, they couldbe like little fragments. Above all, the irritable bowel does not havethe red flags that I mentioned previously, that is the presence of bleeding, very significantrelevant weight loss in a short period of time, no fever, and no vomiting, once we considerthe red flags and if they are not present
in the patient, there are other lab resultsthat we could request to evaluate the patient and exclude something that may be caused byanother illness other than the IBS, the irritable bowel. If a physician requests those labs, they arenot specific. There is no specific blood test to make the diagnosis of an irritable bowel.So what one does when he looks at the lab for help to see if there is anemia, evidenceof bleeding indirectly or directly, a low red cell count, a low iron or something calledferritin, signs of inflammation in the blood. We request a test called Sed rate or CRP thatindirectly look at this aspect.
Other tests may show low protein to suggesta difficult absorption, nutrition, which is not really a main issue when one deals withirritable bowel. So once the red flags are excluded and that the physician is certainabout that, he or she can then say â€œWell I am not yet sure. I need to evaluate my patientproperly.â€� That can be done with xrays such as CAT scan, xray of a small intestine,a barium enema sometimes or proceed to something more specific and definitive, yet somewhatinvasive called a colonoscopy where you look at the lining of the colon. You can take samplesand make sure there is no inflammation. The bottomline is to make sure that thereis no colitis because colitis is treated differently.
It is somewhat of a greater concern to somepatients because it could bleed to serious consequences and disabilities, so it is importantnot to attach diagnosis of IBS, irritable bowel, to someone who may have something thatcan be treated differently and therefore modify their quality of life and outcome. I think that more or less summarizes whatI have been trying to convey about what IBS irritable bowel syndrome is and how to proceedwith a detail specific evaluation of this condition.
Inflammatory bowel disease vs irritable bowel disease
Let meintroduce you to Frank. Now, for most of the last year, Frank's digestive system, it's just not been feeling quite right. He's been having intermittent, although fairly frequent abdominal pain as well as irregular bowel movements. And at times he's not ableto have a bowel movement.
Then at other times he's beenhaving them very frequently. And he was telling a closefriend about these symptoms. And his friend said, you know, Frank, I was watching something on TV, and I heard about this condition. I'm not exactly sure,but I think it was called something like irritable bowel disease. And it sounds somewhat similarto what you're experiencing.
Perhaps you should go see a . So Frank goes to see his . And he says, you know,doc, I think I have IBD. And Frank's says, youknow, I'm sorry to hear that. Please tell me why youthink you may have IBD. And as he's relatingthese symptoms to her, she thinks to herself, youknow, I wonder if he means IBS instead of IBD.
And so his responds, Frank, you know, I'm concerned you may have a condition known as irritable bowel syndrome, which is commonly referred to as IBS. And Frank says, isn't that IBDé And his replies,that's a common mistake. Unfortunately, there aretwo different conditions with very similar acronyms.
They are irritable bowel syndrome or IBS and inflammatory bowel disease or IBD. Let's learn about the differences between IBS and IBD. So let's start on the left here with irritable bowel syndrome or as it's more commonly referred to, IBS. But what exactly is a syndromeé
To help get a better idea,let's think about a car. Now, imagine that something is just not quite right with your car. So you take it into the auto shop. And you tell the mechanic, you know, there's this rattlingsound under the hood. And the car has poor acceleration, and the check engine light is on.