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Patients with IBS can often have a number of other functional disorders such as: Fibromyalgia, chronic fatigue, and also symptoms of anxiety, depression. Fibromyalgia is a disorder where patients develop pain throughout different parts of their body, so it's really important to address the whole patient when managing irritable bowel syndrome because a lot of those other associated conditions can have an impact on the symptomatology of IBS.
Patients with IBS can often have a number of other functional disorders such as: Fibromyalgia, chronic fatigue, and also symptoms of anxiety, depression. Fibromyalgia is a disorder where patients develop pain throughout different parts of their body, so it's really important to address the whole patient when managing irritable bowel syndrome because a lot of those other associated conditions can have an impact on the symptomatology of IBS.
Because IBS is a constellation of symptoms, it is very important to make sure that a thorough history and physical examination is performed to make sure that patients don't have any alarm symptoms or any other signs of other conditions such as inflammatory bowel disease, celiac disease, microscopic colitis, thyroid diseases. All of those conditions can mimic symptoms of irritable bowel syndrome, so it's important for your physician to ask all the necessary questions to exclude these other conditions. Sometimes it's not so clear. They may require blood work. They may require stool tests to rule out infections. They may even require an endoscopy or a colonoscopy if the symptoms are not clear-cut and you have risk factors for some of these other conditions.
IBS is a clinical diagnosis, meaning: if you have the typical symptoms of irritable bowel syndrome (abdominal pain, a change in bowel habits, whether it be diarrhea or constipation and improvement in symptoms with bowel movements are the typical symptoms), so if a person has those and there are no alarming symptoms or clinical signs such as weight loss, bleeding, anemia, and a number of other concerning features - one can make a diagnosis of irritable bowel syndrome. You don't necessarily need to have blood tests or an endoscopy or cat scans or MRIs. Before, it used to be a diagnosis of exclusion, meaning you go to your doctor and he would run the whole gamut of tests and then when nothing was found, they would say it's probably IBS. Now we know that if you meet the symptoms and there are no alarm symptoms, then one can make a diagnosis of irritable bowel syndrome on clinical grounds.
I think it's really important that people who are diagnosed with irritable bowel syndrome make sure that the physician isn't labeling them with irritable bowel syndrome because they don't know what else is wrong with them. Oftentimes patients go to the doctor and they complain of bloating or gas and they have no abdominal pain and their bowel habits are normal - that's not IBS. If you just have abdominal pain but your bowel movements are okay - that's not irritable bowel syndrome. If you're really constipated or you have a lot of diarrhea but you don't have much abdominal pain - that's not IBS. It's really, really important to understand that IBS is a constellation of symptoms and you really need all of those symptoms to be diagnosed as irritable bowel syndrome. If you just come in with abdominal pain, there's so many other things that one could have and it would be inappropriate to diagnose and categorize you as having irritable bowel syndrome. Very important to make sure that your doctor has thoroughly looked at your symptoms and made sure that he's not just labeling you as a patient with irritable bowel syndrome, but rather, in fact, that there's nothing more serious going on.
There are a number of risk factors for irritable bowel syndrome. Being female seems to be a very important risk factor. Having an underlying psychiatric condition such as depression or anxiety is also very, very important. Thirdly, a prior episode of gastroenteritis. What that means is a prior episode of either food poisoning or a GI flu bug - something of that sort. The more severe the episode of gastroenteritis, the more likely one is to develop irritable bowel syndrome.
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