3.What are the most common symptoms? - Irritable Bowel Syndrome

Initial diagnosis
As previously suggested, irritable bowel syndrome is not one recognizable illness, disease or infection. Instead, it is a collection of symptoms that are all grouped together under the same heading for the sake of convenience.

For this reason, there is a problem that when you have an upset stomach, this is almost always exactly what it is – nothing more or less than an upset stomach. And equally obviously, not everyone who suffers an upset stomach is a genuine irritable bowel syndrome sufferer.

For this reason, general descriptions of the symptoms attached to IBS are not always particularly helpful because a suggestion that a term such as ‘changes in your bowel habits’ is representative of IBS does not really get you much further forward.

Because most people who are suffering stomach or bowel problems need to know whether irritable bowel syndrome is their problem, it makes sense to analyze the symptoms in a little more depth.

In order to do so and in the interests of making the description of what IBS is as detailed as possible, I will highlight how your doctor might decide whether you’re suffering from irritable bowel syndrome or not.

As suggested previously, there are no established tests which can be used to prove whether you are suffering from IBS or whether you have nothing more than an upset stomach. Consequently, the science or art of diagnosing irritable bowel syndrome is based upon discounting alternatives that produce IBS-like symptoms to eventually arrive at the correct conclusion. To do this, doctors use many different systems and criteria.

Whilst there are plenty of different algorithmic systems that doctors have used to diagnose IBS (including the Manning Criteria), many of these systems are now considered obsolete, having been replaced by the Rome III Criteria or process which was published in 2006.

This is therefore the system that we will use to try to formulate a reasonably accurate diagnostic symptom list for IBS.

As a patient, you would meet the basic criteria for IBS according to the Rome III process if your symptoms have persisted for a period of at least six months, assuming that during that period of time, you have suffered at least three bouts of difficulties or discomfort every month.

Furthermore, your doctor will be looking for a ‘match’ with at least two out of the three following statements:

• Your pain is relieved when you achieve a successful bowel movement;

• The pain you feel usually occurs at a time when you can identify consistency or appearance changes in your stools and

• Your pain also appears to be linked to alterations in the regularity with which you successfully achieve bowel movements as well.

With a match against two out of these three recognize symptoms of IBS established, your doctor would probably be satisfied that you appear to be suffering from IBS, but they would probe further to confirm the diagnosis.

This would be important because whilst these primary diagnostic requirements are important, they might suggest that irritable bowel syndrome is a condition of which regularity is a feature. This is however not necessarily true.

One of the characteristics of IBS that many sufferers find most frustrating or annoying is the fact that the condition is hardly ever regular. They never have the luxury of knowing what is going to happen next.

Hence, your doctor will probably probe a little deeper to establish whether the degree of irregularity that is characteristic of irritable bowel syndrome is present.
In order to do so, he or she would again look for two matches from this group, although even one match might sometimes be acceptable.

You probably have IBS if:

• Bowel movements often differ in consistency in size, sometimes being small, hard and bullet-like or perhaps thin, stringy or watery at other times;

• The physical action of passing a stool and the feelings associated with it differ from experience to experience. Sometimes, you may have to strain whilst at other times, the urge to go to the toilet hits you like a proverbial express train.

Furthermore, many IBS sufferers report that they often feel as if they have not passed the complete stool from their body as well;

• Bowel movements differ in frequency, sometimes happening two or three times every day (usually as diarrhea), whilst at other times, you may not need the bathroom more than once every three or four days;

• Many times, your stomach feels bloated or gas filled.

If any or more than one of these attendant symptoms are present, your doctor will probably diagnose irritable bowel syndrome.

However, this is still not the end of the story as there are various other symptoms that may or may not be indicative of IBS which your doctor might probe for.

For example, some people who have IBS suffer constipation that is immediately followed by diarrhea, accompanied by a degree of lower abdominal discomfort, whilst others might have the constipation and the pain but not diarrhea.

Then there are a wide range of ‘symptoms’ that your doctor may look for that are not necessarily symptoms of irritable bowel syndrome itself. Instead, many of these additional symptoms are in fact more like pointers to a possible cause of your condition instead of being a symptom of it.

For example, your doctor might question whether you have recently been under any excess stress or if you have been feeling anxious or depressed. If so, these are less likely to be symptoms of irritable bowel syndrome than causative factors.

However, the fact that something (in your doctors thinking, perhaps stress, fatigue or anxiety) has probably caused IBS is the genesis of a vicious circle.

You are stressed so you developed IBS, and as a result of IBS, your stress has got even worse. After all, how can you feel relaxed and comfortable if you know that your digestive system can let you down without prior warning at any time and that you might need to find a toilet immediately when it does?

Your doctor might question whether you have suffered headaches or backache, sleeping problems or urinary difficulties. The latter might be relevant because especially when you have diarrhea, it is common that many people to need to urinate less often, hence this question.

Other folks suffer from sexual problems or heart irregularities and palpitations which at first glance would appear to have nothing to do with a gastrointestinal problem like irritable bowel syndrome.

However, as you will discover many times in this report, stress is generally considered to be an extremely important contributory factor for IBS. As sexual problems and heart palpitations are the kind of problems that healthcare professionals acknowledged to be indicative of stress, hence the question.