Irritable bowel syndrome (also called IBS) is a digestive disease, whose common symptoms include abdominal discomfort, abdominal bloating, and abnormal bowel habits.
Rome criteria dictates that, in order to diagnose IBS, a patient has to exhibit recurring abdominal pain for six or more months, as well as two of the following three symptoms:
- Pain or relief following bowel movements
- Change in frequency of bowel movements
- Change in consistency of bowel movements
According to the National Institute of Diabetes and Digestive and Kidney Diseases, around 12% of people suffer from IBS in North America. It is more common in women and people under the age of 50.
Below, we cover how to diagnose IBS — as well as symptoms and treatments.
Common IBS Symptoms
What are the first signs of irritable bowel syndrome? Here are the most common IBS symptoms:
- Pain relief after defecation
- Feeling of incomplete defecation
- Increased urgency to defecate
- Gas, bloating
- Abdominal pain
- Unintended weight loss
- Mucus in stool
- Rectal bleeding
Types of Irritable Bowel Syndrome
There are two main types of irritable bowel syndrome: IBS-C and IBS-D.
- IBS-C is irritable bowel syndrome with constipation (or constipation-predominant). This is when your abnormal bowel habits result in fewer bowel movements and/or difficulty defecating.
- IBS-D is irritable bowel syndrome with diarrhea (or diarrhea-predominant). This is when your IBS results in uncontrollable bowel movements.
There is also IBS-M, which means “mixed” bowel habits IBS, and IBS-U, which means “unclassified” IBS.
What’s the difference between IBS and IBD?
IBS stands for irritable bowel syndrome. IBS can present as diarrhea-predominant or constipation-predominant. IBS only involves symptoms of the colon.
IBD stands for inflammatory bowel disease. IBD refers to a group of digestive diseases and can cause ulcers/lesions. Crohn’s disease and ulcerative colitis are two examples of IBD. IBD is more serious and disruptive to daily life than IBS.
Labs & Tests Your Doctor May Perform to Diagnose IBS
Tests that your doctor may perform to diagnose IBS:
- Physical examination
- Medical history
- Family history
- Upper endoscopy
- Blood tests
- Stool tests
- Celiac disease test
- Lactose intolerance breath test
- CT scans
- SIBO breath test
Though there is no one test to end all tests, this is a pretty standard array of medical tests to determine if you have IBS, and why. There are so many various tests partly because there are multiple possible causes of IBS.
These tests may be administered by your primary care physician, or he/she may refer you to a gastroenterologist.
A physical examination is the most common test for how IBS is diagnosed.
During a physical examination, your doctor usually checks for abdominal bloating, listens to your abdomen with a stethoscope, and checks your abdomen for any contact pain.
Your doctor may also examine your rectum for rectal bleeding, but this may also be done with a stool test or a medical history.
Your doctor will ask about your medical history, including your recent symptoms.
Ideally, you will have been tracking your symptoms of IBS — perhaps with a simple diary or Notes app.
As long as you do not exhibit any “red flag” symptoms (rectal bleeding, fever, dizziness), identifying multiple IBS symptoms is often enough for many doctors to be confident in an IBS diagnosis without the need of further tests.
Some doctors may ask about antibiotic overuse. Overusing antibiotics can trigger leaky gut syndrome, SIBO, and/or yeast overgrowth which can lead to all sorts of digestive diseases, such as IBS.
Your functional doctor may work with you to determine if you could be experiencing a hormone imbalance. When your hormones are out of whack, your bowels can suffer the consequences.
Functional doctors will almost certainly ask about chronic stress. About a third of American adults experience stress on a daily basis, which can lead to health problems like IBS.
Your doctor will probably ask you about your family’s medical history.
Is there any history in your family of:
- IBD (such as Crohn’s disease or ulcerative colitis)
- Celiac disease
- Lactose intolerance
- Other digestive diseases
- Colon cancer
Functional doctors may also ask if your family has any history of chronic stress, leaky gut syndrome, or autoimmune disorders.
Can IBS be seen on a colonoscopy? No, a colonoscopy does not detect IBS. A colonoscopy rules out the potential alternatives to IBS, such as colon cancer or IBD.
Colonoscopies may be administered to determine whether you have polyps or tumors in your colon.
What is a sigmoidoscopy? A sigmoidoscopy is a procedure where your doctor uses a flexible tube to look in your sigmoid colon.
This is one method to look for IBD, cancer, or intestinal polyps (abnormal growths).
An upper gastrointestinal endoscopy checks for celiac disease and gastric or intestinal ulcers.
At PrimeHealth, we also test for parasites that may be causing your IBS through stool testing. An endoscopy is one way to identify parasites.
A medical professional will procure a blood sample from you and send it to a lab.
Doctors use these blood samples to determine if you have anemia, infection, parasites, or other medical conditions.
A few years ago, Dr. Mark Pimentel developed a two-blood test process called IBS Smart for diagnosing IBS related to prior food-poisoning. . These two blood tests identify the presence of two antibodies: anti-Cdtb and anti-vinculin.
A medical professional will give you a container for catching a stool sample. You’ll probably take the test home, so it comes with instructions on where to bring the test, or where to send it.
Doctors use these stool tests to identify blood or mucus in stool as well as signs of infection or the presence of parasites.
Functional Medicine doctors tend to use more in-depth stool testing than most conventional doctors. Common names for these tests are Genova GI Effects or Diagnostic Solutions GI Map. These tests use DNA PCR analysis to investigate the various types of organisms present in the gut, like bacteria, yeast, and parasites.
They also look at inflammatory markers, enzymes, short chain fatty acids, presence of fat or protein, and more.
Celiac Disease Test
You may need a celiac disease test to figure out if you have celiac disease that is triggering IBS.
Doctors usually test for celiac disease with:
- Blood testing
- Genetic testing
- Antibody testing
Lactose Intolerance Testing
A hydrogen breath test can determine if you have lactose intolerance. An elimination diet would also help you figure out if you have lactose intolerance. This is where you would eliminate all dairy from your diet for at least a few weeks to see if your symptoms resolve.
Lactose intolerance may be the cause of your IBS. Cutting out dairy is a pretty simple (and inexpensive) treatment option, if this turns out to be the cause of your IBS.
X-rays are used to make sure your symptoms are not caused by something other than IBS. Their use is not common in the diagnosis of IBS.
X-rays can be used to identify lesions caused by parasites. Parasites can trigger IBS.
CT scan stands for computerized tomography scan. A CT scan uses special x-ray equipment to show a cross-section of internal organs.
In rare cases, a doctor may order a CT scan to look for digestive diseases that could rule out IBS.
SIBO Breath Test
Small intestine bacterial overgrowth (called SIBO) is usually present in IBS patients.
We have found SIBO testing is very useful, and normally administer a SIBO test on our IBS patients.
Preparing for Your Doctor’s Appointment to Diagnose IBS
Here are some ways to prepare for a doctor’s appointment to diagnose IBS:
- Know your medical history.
- Know your family history. Call relatives if need be.
- Document any symptoms of IBS you experience.
- Keep a food diary.
- Write down any questions you have, so you won’t forget.
Your doctor may instruct you whether to change your dietary habits before the appointment.
Mentally prepare for the potential of a rectal exam and/or taking a stool sample. These will be less uncomfortable if you are mentally prepared for them.
Three At-Home IBS Tests
Are there at-home self-checks for IBS? Yes, there are at-home IBS tests. However, the most accurate test would be to procure a diagnosis from a medical professional.
Nevertheless, here are some at-home self-checks for IBS:
- Candida spit test: This one’s gross, but it has some merit. To test for Candida overgrowth, which often accompanies IBS, spit into a glass of water — first thing in the morning. If it floats for 45 minutes, you’re golden. If it sinks or forms legs, you may have an overgrowth of Candida yeast.
- Food allergy pulse test: Also called the Coca Pulse Test, this one takes patience. Check your pulse, then put food in your mouth for 30 seconds without chewing, then check your pulse again. If your pulse rises six points, you may be allergic to that food.
- Low stomach acid test: First thing in the morning, drink ¼ teaspoon of baking soda in four to six ounces of chilled water. Try to burp. If it takes longer than three minutes to burp, you may have low stomach acid, which can lead to digestive issues like IBS.
Another self-check is identifying when you are particularly stressed, and if your IBS acts up when that stress flares up. Stress can cause bowel disorders.
A Functional Approach to IBS Treatment
These are the most effective IBS treatments we believe in:
- Dietary changes
- Lifestyle changes
Please click here to set up a free phone consultation with us.
Here at PrimeHealth, we believe this functional approach is how to cure IBS permanently. We have seen our functional methods work miracles with hundreds of patients who found no success in conventional medicine.
FODMAPs are foods well-known to trigger digestive health problems. Avoid these FODMAP foods:
- Garlic, onions (contain fructans)
- Fruit (because of fructose)
- Brussels sprouts
- Snow peas
- Agave nectar
- Sugar alcohols
The low-FODMAPs diet is not meant to last very long — no more than a few months. The low-FODMAPs diet is not recommended during SIBO treatment. The anti-SIBO antibiotics are actually more effective when you eat high-FODMAP foods.
This diet is also typically not appropriate during pregnancy, as it may lead to limited caloric or nutrient intake vital to a developing fetus.
Dietary probiotics are great for restoring the balance of good bacteria to your gut. Probiotics simply means “good” bacteria — the microorganisms that your body needs to properly function.
Unfortunately, antibiotic overuse and other bad habits can lead to an imbalance of bacteria in your gut. This causes leaky gut syndrome, and leaky gut can trigger IBS.
Fortunately, probiotics can return your gut to its former glory. Probiotics have been shown to improve IBS symptoms in countless scientific studies.
Some of the best sources for dietary probiotics are:
However, use caution in the probiotics you choose. Many probiotic foods can be FODMAPs.
There are three lifestyle changes that can make short work of IBS in some patients.
- Stress relief is an effective method of lowering your risk of IBS. Meditation, yoga, a full night’s sleep, and spending time in the outdoors are all ways to get rid of daily stress.
- Exercise may lower risk of IBS. Studies show that physically active people are significantly less likely to exhibit IBS symptoms than inactive people.
- Intermittent fasting might relieve your IBS symptoms. If you’re eating too much too quickly, your digestive tract can’t properly process what you’re eating. Fasting in the mornings or evenings may fix the problem. Start with a fasting window of 12 hours, then work your way to a 16-hour break between dinner and breakfast the next day.
- Time between meals without snacking of at least 4 hours can also be helpful, as your body needs at least 4 hours without food to activate emptying via peristalsis. The nerves responsible for peristalsis in the small intestines are called the migratory motor complex.
There are several medications we might prescribe our patients, especially if they aren’t responding to dietary and lifestyle changes. Keep in mind that over-the-counter medications listed below are meant to treat short-term symptoms and are not a cure for IBS.
- Rifaximin or Xifaxan is an antibiotic that treats IBS-D and IBS-C. Many insurance companies won’t pay its high price tags, so we utilize pharmacies in Canada where the price is much more reasonable.
- Neomycin is an antibiotic we might prescribe for IBS-C along with rifaximin.
- Metronidazole or tinidazole are good antiparasitic antibiotics that we may prescribe if the patient has parasites.
- Lubiprostone is a laxative that some doctors prescribe for IBS-C.
- Prucalopride is a promotility medication that helps activate the migratory motor complex and peristalsis.
You can get IBS medication over the counter as well:
- Loperamide (Imodium) helps control diarrhea.
- Dicyclomine (Merbentyl) is an antispasmodic, which means it relaxes your gut muscles.
- Bismuth subsalicylate (Pepto-Bismol) is an antacid that treats indigestion and diarrhea.
Biofilm disruptors, like Interfase Plus, may be necessary to fight harmful bacteria that form a protective biofilm.
Painkillers only treat the symptoms of IBS, instead of the root cause. However, relieving pain and inflammation in your digestive tract can offer short-term improvement in your quality of life while you address the underlying cause.
Here are some all-natural painkillers that don’t come with those nasty side effects:
- Oregano oil
- Peppermint oil
- Rosemary oil
How to Cure IBS in One Day
For some, what triggers their IBS can be resolved in a day. If your IBS is triggered by something simple, this checklist may help cure your IBS in one day.
- Avoid gassy foods, like beans, brussels sprouts, carbonated beverages, and caffeine.
- Avoid gluten and lactose. Not only do they cause inflammation that could lead to IBS, but you could have a food allergy and not know it.
- You may be eating too much or too little fiber.
Unfortunately, not everyone’s IBS symptoms can be resolved in one day. But there are easy first steps to determine whether you need to see a doctor.
Looking to an IBS-Free Future
Irritable bowel syndrome is treatable. Our patients prove it. There is hope. You may have to make simple changes to your lifestyle or diet, but IBS is not a permanent disease.
Our functional approach to IBS treatment is supported by research and our patients who have recovered. When you look to the future, rest assured you can imagine it without IBS.
— Medically reviewed by Soyona Rafatjah, MD. on May 26, 2020
- Chey, W. D., Kurlander, J., & Eswaran, S. (2015). Irritable bowel syndrome: a clinical review. Jama, 313(9), 949-958. Full text: https://www.researchgate.net/profile/William_Chey2/publication/275639401_Irritable_Bowel_Syndrome_a_clinical_review/links/5540e0ea0cf2b790436af4f1/Irritable-Bowel-Syndrome-a-clinical-review.pdf
- Lacy, B. E., & Patel, N. K. (2017). Rome criteria and a diagnostic approach to irritable bowel syndrome. Journal of clinical medicine, 6(11), 99. Full text: https://www.researchgate.net/publication/320643280_Rome_Criteria_and_a_Diagnostic_Approach_to_Irritable_Bowel_Syndrome
- Patel N, Shackelford K. Irritable Bowel Syndrome. [Updated 2020 Jan 3]. Irritable Bowel Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Full text: https://www.ncbi.nlm.nih.gov/books/NBK534810/
- Reding, K. W., Cain, K. C., Jarrett, M. E., Eugenio, M. D., & Heitkemper, M. M. (2013). Relationship between patterns of alcohol consumption and gastrointestinal symptoms among patients with irritable bowel syndrome. The American journal of gastroenterology, 108(2), 270. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3697482/
- Qin, H. Y., Cheng, C. W., Tang, X. D., & Bian, Z. X. (2014). Impact of psychological stress on irritable bowel syndrome. World journal of gastroenterology: WJG, 20(39), 14126. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202343/
- Pimentel, M., Morales, W., Rezaie, A., Marsh, E., Lembo, A., Mirocha, J., … & Barlow, G. M. (2015). Development and validation of a biomarker for diarrhea-predominant irritable bowel syndrome in human subjects. PLoS One, 10(5). Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430499/
- Dale, H. F., Rasmussen, S. H., Asiller, Ö. Ö., & Lied, G. A. (2019). Probiotics in Irritable Bowel Syndrome: An Up-to-Date Systematic Review. Nutrients, 11(9), 2048. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769995/
- Hirotsu, C., Tufik, S., & Andersen, M. L. (2015). Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Science, 8(3), 143-152. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688585/
- Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns. Landscape and urban planning, 105(3), 221-229. Full text: https://www.sciencedirect.com/science/article/pii/S0169204611003665
- Johannesson, E., Simrén, M., Strid, H., Bajor, A., & Sadik, R. (2011). Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. American Journal of Gastroenterology, 106(5), 915-922. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/21206488
- Chung, M. K., & Campbell, J. N. (2016). Use of capsaicin to treat pain: mechanistic and therapeutic considerations. Pharmaceuticals, 9(4), 66. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198041/