Recent stressful events in your life. Stress
may be a strong indication that your symptoms may be caused by irritable bowel
Bowel function, including how many bowel movements you
have per day or per week, whether you have constipation or diarrhea, whether
you have noticed any blood or mucus in your stool, and any recent changes in
your bowel habits or the shape of your stools.
Whether your bowel
movement patterns have any relationship to your abdominal pain (for example, if
passing a stool relieves the pain and cramping).
may increase your risk of an intestinal infection, such as foreign travel,
drinking untreated water, or recent antibiotic use.
The dietary history will include questions about food
allergies and whether your symptoms seem to be related to any particular foods.
Foods that most commonly cause symptoms include lactose (milk sugar) and
sorbitol, an artificial sweetener found in sugarless chewing gum and other
Irritable bowel syndrome (IBS) is among the most common intestinal maladies
and one of the most difficult to treat. No single remedy works for everybody,
and there are few drugs created exclusively for IBS symptoms, which include
abdominal pain, cramping, bloating, diarrhea, and/or constipation.
"I look at it this way: I don't have a lot of great things in conventional
medicine to offer, so what I do have is in the realm of natural therapy," says
Tieraona Low Dog, MD, a clinician and professor...
A medical history and physical
examination are standard tests for people who have abdominal pain and changes
in bowel habits.
Key findings in IBS are abdominal pain that
is relieved with a bowel movement and a change in the consistency or number of
times per day or week that you have bowel movements. The pain is not limited to
one part of the abdomen. It may move around and may come and go. It often
occurs or gets worse when you eat. Stress may also be related to abdominal
The abdomen may be swollen if you have gas in the
intestines. Your abdomen may be tender when the doctor presses on it. Abnormal
bowel sounds may be heard, especially, but not only, if you have diarrhea. You
may report symptoms such as an urgent need to have bowel movements or a feeling
that you haven't completely emptied the bowel after passing a stool.
A person who has IBS may have constipation more often, diarrhea more
often, or constipation that alternates with diarrhea.
physical findings should be normal for a diagnosis of IBS.
What To Think About
Because there is no detectable
structural problem that causes IBS, if you have a normal physical exam but you do have symptoms
of IBS, this strongly suggests that you have irritable bowel syndrome. If your doctor thinks your symptoms may be caused by another problem, he or she may recommend other tests, such as:
Blood tests (complete blood count [CBC] and/or
sedimentation rate), to rule out anemia, inflammation, or
Test for blood in the stool (fecal occult blood test),
to check for bleeding in the intestinal tract or white blood cells in the stool
(a sign of inflammation or infection in the intestines).
parasites in the stool, to check whether a parasitic infection, such as
giardiasis, is causing symptoms.
Your doctor may recommend other tests not in this list. But if there are no symptoms (such as anemia, rectal bleeding
or bloody diarrhea, fever, weight loss, pain that wakes you at night, or recent
change in bowel habits) that suggest other intestinal diseases, few additional
tests are needed. If these symptoms are present, tests for other problems, such
inflammatory bowel disease or an ulcer, may be