IRRITABLE BOWEL SYNDROME (IBS) - DIAGNOSIS

There is no simple test for IBS. Diagnosis is made based on symptoms and excluding other possible causes for your symptoms. Therefore, your doctor will ask you questions about your symptoms and then perform an examination of your abdomen and/or your back passage (a rectal examination). Depending on your risk factors, some simple tests may be done. You may also need a referral to a specialist for further tests.

Rome II Criteria:

The Rome II criteria (more recently the Rome III criteria has been issued, incorporating some changes to the Rome II criteria) is used to help physicians diagnose IBS. It specifies that people with IBS should have suffered from abdominal pain for 12 consecutive week during the past 12 months. The pain should have 2 of the following 3 features:

1.  It is relieved by having a bowel movement.
2.  It is associated with a change in stool frequency.
3.  It is associated with a change in the appearance of stools.

Other features that cumulatively support the diagnosis of IBS include:

• Abnormal stool frequency (normal stool frequency being defined as having between 3 bowel movements per day to 3 bowel movements per week)

• Abnormal stool form (hard or loose/watery stools)

• Abnormal stool passage (urgency, excessive straining, or feeling of incomplete evacuation)

• Feeling of abdominal bloating/distention.

Tests performed may include:

• Full Blood Count (FBC) with Electrocyte Sedimentation Rate (ESR):

The FBC is done to check for anemia or signs of infection. A raised ESR level indicates likely inflammation.

• CEA levels:

CEA is a marker used for colon cancer. In patients with colon cancer, CEA levels are typically significantly raised. There are, however, also other causes of raised CEA levels.

• Stool analysis:

Stools for faecal occult blood are done as a screen for colon cancer. In the diarrhoea-predominant type of IBS, stools may be sent for culture to check for bacteria, eggs of worms, cysts or parasites.

• Colonoscopy:

Patients above 50 years of age, those at risk of colon cancer, or those with alarm bell symptoms or signs, should have a colonoscopy done by a specialist.

• Thyroid Function Tests:

Abnormally high or low levels of thyroid hormones can cause diarrhoea or constipation respectively.

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