As a dietitian specialising in Irritable Bowel Syndrome I usually begin my consultations by discussing how the patient feels about their diagnosis. Many of my patients instead of being reassured by their diagnosis find it very hard to accept that it’s “only Irritable Bowel Syndrome”. For many this feels like a non-diagnosis with the connotation of being “all in the mind”. Others feel that their GP has not fully understood the severity of their symptoms and has surely missed something.
So what exactly does this diagnosis mean?
Far from dismissing your symptoms your GP brain will have been whirring, considering your past medical history, while listening to your explanation and questioning you further to uncover and “red flag” symptoms which my indicate other serious conditions.
If you do have any of these red flag symptoms such as; unexplained weight loss, rectal bleeding or family history of bowel or ovarian cancer, your GP may at this point refer you for further investigations.
Having ruled out these ‘red flags’ you GP should have checked your abdomen and carry out some simple blood tests. These tests look at inflammatory markers, haemoglobin and antibodies and can rule out anaemia, inflammatory bowel disease and coeliac disease. In women they may also be tested for signs of ovarian cancer.
During the consultation your GP will have been listening to your symptoms and looking for additional clues to support the diagnosis, such as:
- abdominal pain of discomfort which is relieved when you poo
- altered bowel frequency or stool consistency
- altered stool passage such as straining, urgency or incomplete evacuation
- abdominal bloating, distension, tension or hardness
- symptoms made worse by eating
- passage of mucus
- bladder symptoms
Getting the most out of your GP consultation
While this discussion may be difficult, now is the time to bring up additional concerns that you may have (be reassured that your GP will have heard it all before). For some flatulence may be the most difficult symptom or you may be one of the 25% of IBS sufferers who have experienced faecal incontinence(1). It may be helpful to spend a few minutes before talking to your GP to write down all of your symptoms.The more information that you can provide the better able your GP with be to provide an accurate diagnosis.
So while it may seem on the surface a ‘non-diagnosis’, your GP will have been paying attention to rule out alternative diagnoses and more sinister or life threatening causes of your symptoms.
Do not self diagnose IBS!
It is very important that you do not self-diagnose IBS as the symptoms can be remarkably similar to conditions such as coeliac disease, endometriosis, inflammatory bowel conditions and bowel or ovarian cancer all of which your GP will have considered before giving your diagnosis.
From a dietitian’s point of view please make sure that you have been tested for Coeliac disease before making any dietary changes as excluding wheat & gluten will invalidate future blood tests.
(1) International Foundation for Functional Gastrointestinal Disorders. IBS in the Real World. IBS Research Findings by IFFGD. August 2002.