Is It Irritable Bowel Syndrome? Your Digestive Symptoms

Q: Is It Irritable Bowel Syndrome? Your Digestive Symptoms

Dear Ms. <br>Chen：<br>1. <br>The diagnosis of Irritable Bowel Syndrome (IBS) lacks effective physical examination or biochemical blood markers. <br>It is generally accepted that abdominal pain lasting more than three months, occurring more than three days per month, along with an

Is it irritable bowel syndrome?

Hello, Dr.
Hsiao! I would like to ask you some questions...
For the past few months (over 3 months), I have been experiencing some unusual bowel habits.
I have been having bowel movements 4-5 times a day, and about 10 minutes after eating, I feel the urge to have a bowel movement.
This happens every time.
Sometimes my stools are loose, sometimes they are soft, and other times they are fragmented.
Since these symptoms have persisted for several months, it has been quite bothersome and inconvenient for me to go out.
Could this be a symptom of irritable bowel syndrome, or is there something wrong with my gastrointestinal system? I also have a history of peptic ulcers and gastroesophageal reflux disease (GERD)!

Chen, 20~29 year old female. Ask Date: 2016/05/29

Dr. Xiao Yongxun reply Internal Medicine

Dear Ms.
Chen:
1.
The diagnosis of Irritable Bowel Syndrome (IBS) lacks effective physical examination or biochemical blood markers.
It is generally accepted that abdominal pain lasting more than three months, occurring more than three days per month, along with any two of the following criteria, can be diagnosed as IBS: a.
Abdominal pain typically improves after bowel movements.
b.
Abdominal pain is associated with a change in bowel frequency.
c.
Abdominal pain is associated with a change in stool form or appearance.
2.
Due to the nonspecific nature of IBS symptoms, it is necessary to differentiate it from many other conditions, including colorectal tumors, inflammatory bowel disease, hyperthyroidism or hypothyroidism, parasitic infections, small intestinal bacterial overgrowth, gluten intolerance, lactose intolerance, carcinoid syndrome, endometriosis, depression, panic disorder, anxiety disorders, and others.
3.
Your situation certainly cannot rule out the possibility of IBS; however, it is essential for you to consult a gastroenterologist or your family physician for a detailed discussion.
You should be particularly cautious if you experience symptoms such as positive fecal occult blood, rectal bleeding, anemia, fever, weight loss, elevated inflammatory markers, increased white blood cell count, abnormal serum electrolyte levels, recent antibiotic use, a family history of colorectal cancer, a family history of IBS, a family history of gluten intolerance, progressively worsening abdominal pain, or sleep disturbances.
4.
Gastric ulcers and gastroesophageal reflux disease are less likely to present with the symptoms you described.
However, it is still advisable to avoid coffee, tea, and alcoholic beverages, refrain from overeating or eating too quickly, and engage in regular physical activity.
5.
Diagnosing a condition should not be based on preconceived notions; it must be based on symptoms, medical history, family history, and imaging studies to arrive at an accurate conclusion.
Therefore, please ensure you seek a physician's diagnosis.
Best regards.

Reply Date: 2016/05/29

More Info

Based on the symptoms you've described, it is indeed possible that you are experiencing Irritable Bowel Syndrome (IBS), but it is essential to consider other potential gastrointestinal issues as well. IBS is a functional gastrointestinal disorder characterized by a combination of symptoms, including abdominal pain, bloating, and changes in bowel habits, such as diarrhea or constipation. The Rome IV criteria, which are commonly used to diagnose IBS, state that symptoms must be present for at least 12 weeks, with abdominal pain occurring at least one day per week and associated with changes in stool frequency or appearance.

Your symptoms of frequent bowel movements (4-5 times a day), urgency to defecate shortly after eating, and varying stool consistency (ranging from loose to soft to fragmented) align with the typical presentation of IBS. Additionally, the fact that your symptoms have persisted for over three months further supports this possibility. However, IBS is a diagnosis of exclusion, meaning that other conditions must be ruled out before confirming it.

Given your history of gastric ulcers and gastroesophageal reflux disease (GERD), it is crucial to consider how these conditions might interact with your current symptoms. While IBS primarily affects the large intestine, the gastrointestinal system is interconnected, and issues in one area can influence another. For instance, certain medications used to treat ulcers or GERD may have side effects that could exacerbate IBS symptoms.

Moreover, it is essential to rule out other potential causes of your symptoms, such as inflammatory bowel disease (IBD), infections, or even food intolerances like lactose intolerance or celiac disease. Symptoms such as blood in the stool, significant weight loss, or persistent fever would warrant immediate medical evaluation, as they could indicate more serious conditions.

To manage your symptoms effectively, it is advisable to consult with a gastroenterologist who can conduct a thorough evaluation, including a detailed medical history, physical examination, and possibly additional tests such as blood tests, stool tests, or imaging studies. This comprehensive approach will help identify any underlying issues and guide appropriate treatment.

In the meantime, dietary modifications can be beneficial. Many individuals with IBS find relief by keeping a food diary to identify potential triggers, such as high-fat foods, caffeine, alcohol, or certain carbohydrates known as FODMAPs. A low-FODMAP diet, which involves reducing the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, has been shown to alleviate symptoms in many patients with IBS.

Stress management techniques, such as mindfulness, yoga, or cognitive-behavioral therapy, may also help reduce the frequency and severity of IBS symptoms, as stress is known to exacerbate gastrointestinal issues. Regular physical activity can further support digestive health and improve overall well-being.

In conclusion, while your symptoms may suggest IBS, it is crucial to seek professional medical advice to rule out other conditions and receive a tailored treatment plan. By addressing both the physical and psychological aspects of your symptoms, you can work towards achieving better digestive health and improving your quality of life.

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