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Online clinic on bowel issues & IBS - Apr 2018

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How to successfully diagnose IBS

Postby magiksen on Wed Apr 11, 2018 10:50 am

I’d like to know if a colonoscopy and endoscopy are vital to diagnose IBS?
My doctor said it wasn’t necessary but I met a gastroenterologist who said he would only diagnose once these procedures had been done. I didn’t go for them and wonder if I should have.
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Re: How to successfully diagnose IBS

Postby Dr Christopher Black on Fri Apr 20, 2018 4:35 pm

Hi magiksen,

An endoscopy and colonoscopy are not a requirement to diagnose IBS. I don't agree that IBS can only be diagnosed if someone has had normal endoscopies. This gives the impression that IBS is diagnosed only when all other conditions have been excluded which is the wrong way to look at it, and often unhelpful. However, limited tests, such as a blood test to exclude coeliac disease (wheat allergy), and a stool test to look for inflammation if someone has diarrhoea (called calprotectin) are to be recommended.

Whether an endoscopy and colonoscopy are recommended should depend on the individual patient. For example, a 25 year old person with bloating, diarrhoea, and crampy tummy pain with no worrying features like weight loss or rectal bleeding and with normal stool and blood tests is highly likely to have IBS. Endoscopy tests won't add anything useful and have some risks which aren't justified here I would argue.

However, if the same person developed these symptoms when they were 60 years old, it could still be IBS, but other conditions are much more common at that age. Even if they had normal stool and blood tests, I would arrange a colonoscopy to ensure there was nothing else going on in the bowel.

I hope this helps to explain things a little more. I don't know anything about your age, symptoms, or what tests you have had. If you are worried about the situation at all I would suggest you go back again to discuss things with your GP.

Kind regards,
Dr Christopher Black
Clinical Research Fellow in Gastroenterology, MBBS MRCP

http://www.talkhealthpartnership.com/online_clinics/experts/dr_christopher_black.php
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