Irritable Bowel Syndrome: Symptoms and Diagnosis - Gastroenterology and Hepatology

Is it irritable bowel syndrome (IBS)?

Hello, doctor.
Recently, I often feel that my bowel movements are incomplete.
There is no blood in my stool, and I don't experience abdominal bloating, but sometimes my stomach makes gurgling noises.
I have already visited a nearby gastroenterology clinic, and the doctor diagnosed me with rapid intestinal motility and prescribed some medication.
I have to go to the bathroom at least three times a day, and sometimes I notice a small amount of stool on the toilet paper after wiping.
Could this be irritable bowel syndrome? The doctor at the clinic didn't suggest a colonoscopy or check for intestinal inflammation since I am young.
I am really distressed, and it has started to affect my daily life.

L, 20~29 year old female. Ask Date: 2012/04/27

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello Mr./Ms.
L, based on the symptoms you described, it is indeed possible that you are experiencing irritable bowel syndrome.
However, a small portion of cases may involve inflammatory bowel disease.
If adjustments to your medication and lifestyle (such as increasing exercise, hydration, and consumption of fruits and vegetables) do not lead to improvement, it is advisable to undergo further examination.
Thank you for your inquiry.
The Changhua Hospital cares about your health.
Dr.
Yang Chih-Chao.

Reply Date: 2012/04/27

More Info

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder characterized by a combination of symptoms, including abdominal pain, bloating, and changes in bowel habits, such as diarrhea or constipation. Your symptoms, including frequent bowel movements, a feeling of incomplete evacuation, and the gurgling sounds in your abdomen, align with the typical presentation of IBS.
IBS is classified into different subtypes based on the predominant bowel habit: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), and mixed IBS (IBS-M). Given your description of frequent trips to the bathroom and the sensation of not fully evacuating, it seems you may be experiencing IBS-D.
The diagnosis of IBS is primarily clinical, meaning it is based on your symptoms and medical history rather than specific tests. According to the Rome IV criteria, IBS can be diagnosed if you have recurrent abdominal pain, on average, at least one day per week in the last three months, associated with two or more of the following criteria: pain related to defecation, a change in the frequency of stool, or a change in the form (appearance) of stool. Since you have been experiencing these symptoms for an extended period, it is reasonable to consider IBS as a potential diagnosis.

However, it is crucial to rule out other conditions that can mimic IBS symptoms. These include inflammatory bowel diseases (like Crohn's disease or ulcerative colitis), infections, celiac disease, and even colorectal cancer, especially given your family history of colorectal cancer. While your doctor may have deemed a colonoscopy unnecessary at this stage, it is essential to communicate your concerns and symptoms clearly. If you experience any alarming signs, such as blood in your stool, significant weight loss, or persistent abdominal pain that disrupts your daily life, further investigation, including a colonoscopy, may be warranted.

In terms of management, lifestyle and dietary modifications can significantly impact IBS symptoms. Many patients find relief by identifying and avoiding trigger foods, which can vary from person to person. Common triggers include high-fat foods, dairy products, caffeine, and certain types of carbohydrates known as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). Keeping a food diary can help you identify patterns and triggers related to your symptoms.

Additionally, stress management techniques, such as mindfulness, yoga, or cognitive-behavioral therapy, can be beneficial, as stress often exacerbates IBS symptoms. Medications may also be prescribed to help manage specific symptoms, such as antidiarrheals for diarrhea or laxatives for constipation.

In summary, while your symptoms are consistent with IBS, it is essential to maintain open communication with your healthcare provider about your concerns and the impact of these symptoms on your quality of life. If your symptoms persist or worsen, seeking a second opinion or further evaluation may be necessary to ensure a comprehensive approach to your gastrointestinal health.

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