Irritable Bowel Syndrome Message Boards | Re: IBS-D - Dr.'s

One more where you might also want to read the whole thread.

"like celiac disease, food allergies, infections and parasites. If you test for these things, and find one or more, then you know what to treat, and you can end the IBS. "

None of the above causes are the "cause" of IBS symptoms. All of the above are seperate entities and are ruled out to make an IBS diagnoses in the first place.

IBS is NOT every gi symptom.

Postinfectious Irritable Bowel Syndrome -- A Real and Distinct Entity

http://www.medscape.com/viewarticle/562539

Diagnosis of Irritable Bowel Syndrome
from Medscape General Medicine [TM]

The Clinical Presentation of IBS
The diagnosis of IBS is determined by certain symptom clusters that "breed true" as a distinct clinical entity. The evidence for and features of these specific symptoms are discussed below.

http://www.medscape.com/viewarticle/407962_2

Symptoms of IBS

"There are no physical findings or diagnostic tests that confirm the diagnosis of IBS. Diagnosis involves identifying certain symptoms consistent with the disorder and excluding other medical conditions that may have a similar clinical presentation. The symptom-based Rome diagnostic criteria for IBS emphasize a positive diagnosis rather than exhaustive tests to rule out other diseases. These criteria are based on the presentation of a specific set of symptoms. In addition, a detailed history, a physical examination, and limited diagnostic tests help confirm this diagnosis with a high level of confidence. Extensive testing may be reserved for specific situations."

http://www.aboutibs.org/site/about-ibs/symptoms/

Diagnosis of IBS
An occasional bout with abdominal pain and diarrhea or constipation is an experience nearly everyone has in common. People may view these symptoms as normal, even when they frequently occur. However, chronic and recurring symptoms are not normal. They may signal IBS. A doctor can provide a diagnosis.

The diagnosis of IBS currently is based on a pattern of symptoms that fit established criteria, in conjunction with a detailed history, a physical examination, and tests that rule out other identifiable causes.

However, there are no physical findings or diagnostic tests that confirm the diagnosis of IBS. Therefore, diagnosis of IBS involves identifying certain symptoms consistent with the disorder and excluding other medical conditions that may have a similar clinical presentation.

The first step in making a positive diagnosis of IBS is for a doctor to identify if an individual has the symptoms of IBS. This is best determined by the use of the Rome Criteria, which is a collection of the most common symptoms that typify the disorder. These include:

http://www.aboutibs.org/site/about-ibs/symptoms/diagnosis

Some of the other, because there are many and ones you don't even mention, are other "excluding other medical conditions that may have a similar clinical presentation."

Most of which can and often do cause "red flag" symptoms, such as celiac and infections and parasites. Some cause symptoms that discriminate between IBS and say food allergies, because food allergies don't cause the VERY SPECIFIC clustering of IBS symptoms.

Do Physicians Follow Evidence-Based Guidelines in the Diagnostic Work-up of IBS?
Posted 06/21/2007

Brennan MR Spiegel

IBS is a chronic disorder of gastrointestinal function that is characterized by recurrent abdominal pain and altered bowel habits in the absence of detectable organic disease. Although IBS is extremely prevalent, affecting up to 15% of the general adult population,[1] its diagnosis is not always straightforward for several reasons: IBS has no consistent biological marker, which leaves clinicians to rely on patient symptoms alone to make the diagnosis; the symptoms of IBS are often difficult to quantify objectively; and many organic conditions can masquerade as IBS. The last fact is the most troubling to both clinicians and patients, many of whom are unsettled by the prospect that alternative diagnoses have been overlooked (such as IBD, microscopic colitis, infectious colitis, small intestinal bacterial overgrowth, celiac sprue, and colon neoplasia, among many others). This uncertainty often prompts clinicians to approach IBS as a diagnosis of exclusion, by performing tests to exclude alternative etiologies.

Conversely, the Rome III criteria encourage clinicians to make a positive diagnosis of IBS on the basis of validated symptom criteria, and emphasize that IBS is not a diagnosis of exclusion.[1] This recommendation is based on extensive evidence[2] that diagnostic tests generally have a very low yield in patients who fulfil the Rome criteria but who otherwise lack alarm signs or symptoms. Vanner et al. demonstrated that Rome-criteria symptoms have a positive predictive value of 98% for diagnosing IBS.[3] In other words, 98% of patients with Rome-criteria symptoms have IBS, rather than an underlying organic condition, after undergoing standard evaluations.

http://www.ibsgroup.org/forums/index.php?showtopic=91083

http://www.ibsgroup.org/forums/index.php?showtopic=96518

There seems to be a nwer blood test out for IBS, however I am still looking in to it some and believ at this point it just helps more on the diagnoses.

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My website on IBS is www.ibshealth.com

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