What is Irritable Bowel Syndrome (IBS) and how do doctors check for it?!

What is Irritable Bowel Syndrome (IBS) and how do doctors check for it?

Irritable bowel syndrome (IBS) is one of the most common disorders that doctors see. Yet it's also one that many people aren't comfortable talking about. Irritable bowel syndrome is characterized by abdominal pain or cramping and changes in bowel function — including bloating, gas, diarrhea and constipation — problems most people don't like to discuss. What's more, for many years irritable bowel syndrome was considered a psychological rather than a physical problem.

Up to one in five American adults has irritable bowel syndrome. The disorder accounts for more than one out of every 10 doctor visits. For most people, signs and symptoms of irritable bowel disease are mild. Only a small percentage of people with irritable bowel syndrome have severe signs and symptoms.

Fortunately, unlike more serious intestinal diseases such as ulcerative colitis and Crohn's disease, irritable bowel syndrome doesn't cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer. In many cases, you can control irritable bowel syndrome by managing your diet, lifestyle and stress.

Although as many as one in five American adults has signs and symptoms of irritable bowel syndrome, fewer than half seek medical help. Yet it's important to see your doctor if you have a persistent change in bowel habits or if you have any other symptoms of IBS.

Your doctor may be able to help you find ways to relieve symptoms as well as rule out other more serious colon conditions, such as ulcerative colitis and Crohn's disease, which are forms of inflammatory bowel disease, and colon cancer. He or she can also help you avoid possible complications from problems such as chronic diarrhea.

Screening and diagnosis

A diagnosis of irritable bowel syndrome depends largely on a complete medical history and physical exam. Your doctor may also recommend conducting several tests, including stool studies to check for infection or malabsorption problems. Among the tests that you may undergo to rule out other causes for your symptoms are the following:

* Flexible sigmoidoscopy. This test examines the lower part of the colon (sigmoid) with a flexible, lighted tube (sigmoidoscope).
* Colonoscopy. In some cases, your doctor may perform this diagnostic test, in which a small, flexible tube is used to examine the entire length of the colon.
* Computerized tomography (CT) scan. CT scans produce cross-sectional X-ray images of internal organs. CT scans of your abdomen and pelvis may help your doctor rule out other causes of your symptoms.
* Lactose intolerance tests. Lactase is an enzyme you need to digest the sugar found in dairy products. If you lack this enzyme, you may have problems similar to those caused by irritable bowel syndrome, including abdominal pain, gas and diarrhea. To find out if this is the cause of your symptoms, your doctor may order a breath test or ask you to exclude milk and milk products from your diet for several weeks.
* Blood tests. Celiac disease (nontropical sprue) is sensitivity to wheat protein that also may cause symptoms like those of irritable bowel syndrome. Blood tests may help rule out that disorder.

Criteria for making a diagnosis
Because there are usually no physical signs to definitively diagnose irritable bowel syndrome, diagnosis is often a process of elimination. To help in this process, researchers have developed diagnostic criteria, known as Rome criteria, for IBS and other functional gastrointestinal disorders — conditions in which the bowel appears normal but doesn't function normally.

According to these criteria, you must have certain signs and symptoms before a doctor diagnoses irritable bowel syndrome. The most important are abdominal pain and diarrhea or constipation lasting at least 12 weeks, though they don't have to occur consecutively. You also need to have at least two of the following:

* A change in the frequency or consistency of your stool. For example, you may change from having one normal, formed stool every day to three or more loose stools daily. Or you may have only one hard stool every three to four days.
* Straining, urgency or a feeling that you can't empty your bowels completely.
* Mucus in your stool.
* Bloating or abdominal distension.

Signs and symptoms

The signs and symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:

* Abdominal pain or cramping
* A bloated feeling
* Gas (flatulence)
* Diarrhea or constipation — people with IBS may also experience alternating bouts of constipation and diarrhea
* Mucus in the stool

Like many people, you may have only mild signs and symptoms of irritable bowel syndrome. Sometimes these problems can be disabling, however. In some cases, you may have severe signs and symptoms that don't respond well to medical treatment. Because symptoms of irritable bowel syndrome can be present with other diseases, it's best to discuss these symptoms with your doctor.

For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.