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The irritable bowel syndrome (IBS) is diagnosed on the basis of clinical symptoms using well formulated criteria. The diagnostic test are required to rule out other conditions that can also seem like IBS or to rule out any complications of IBS.
Doctor would take a detailed history of the symptoms, followed by physical examination and may advise some basic lab tests. Doctor may also advice some additional tests if he wants to rule out other possibilities that may produce similar symptoms.
Detailed clinical history: The doctor would enquire about the abdominal complaints and would take a detailed history of each compliant:
Abdominal pain: the doctor would like to know about the type of pain. Does it decrease or relieves after passing stools.
Frequency of the stool: if the frequency of passing stools has increased or decreased from your regular routine. Feeling of incomplete passage of stools.
Consistency of the stool: if the stools are solid, hard, and lumpy or if they are thin, watery or loose. If the stools have both the consistency.
Bloating: if there is feeling bloating and distention of the abdomen.
Change in color of the stool: if there is blood in the stool or black colored and tarry stools.
Bleeding from rectum
Weight loss: If there’s weight loss.
Fever: may indicate gut infection.
Nausea or vomiting
Fatigue: if there’s a feeling of excessive tiredness
Mood or behavioral changes: if there’s any feeling of anxiety, worry or stress at the start of the symptoms. If a person feels low, depressed and less interested in the surroundings.History or any significant stressful event in the past.
Aggravating or relieving factors: if there are any factors that worsens or initiates the problem like any particular food item, menstrual cycles etc.
Family history: any family member having similar complaints or diagnosed with IBS, inflammatory bowel disease or colonic cancer.
Drug history: Any medicines being taken.
The doctor may diagnose IBS, if there is pain in abdomen once in a week for last 3 months along with at least two of the following symptoms:
• Pain and discomfort related to the passing of the stools. eg: pain improves or get worse after passing stools.
• There is a change in the frequency of passing stools.
• There is a change in the way how feces look.
During the physical exam, the doctor would start with a basic general examination of the body and then would move on to abdominal examination where he might check for:
• Abdominal bloating
• Palpate or taps the abdomen to look for tenderness or pain
• Listens to abdominal sounds with a stethoscope
The doctor might do a rectal examination by putting finger in the rectum to feel for any abnormality.
Generally, the doctors don’t advice for any test to diagnose IBS. Doctor may ask for few tests like blood tests, stool tests, and other tests to check for any other condition that may present with same symptoms.
This is done to check for other conditions like infection, anemia, or digestive diseases.
This is done to check for infection (bacteria or parasite), blood or fat present in the stool.
Other additional tests
The doctor may advice additional tests to rule out other conditions that may mimic IBS. These test may include:
• Colonoscopy: to rule out conditions such as inflammatory bowel disease or colon cancer.
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