Irritable bowel syndrome (IBS) is a common digestive condition that affects up to 16% of Americans. It’s also one with symptoms that make it easily confused with other gut issues.
If you’re experiencing digestive woes, don’t just assume you’re dealing with IBS. “It’s important to talk to your doctor and get an accurate diagnosis,” says Rafat Rizk, M.D., a gastroenterologist at Henry Ford Health. “By asking the right questions, they can determine if it’s IBS and rule out potentially more serious illnesses.”
Common Symptoms of Digestive Disorders
Part of the reason it can be tricky to get an accurate diagnosis of a digestive disorder is that these conditions share many similar symptoms. IBS, inflammatory bowel disease (IBD, which includes Crohn’s disease and ulcerative colitis), microscopic colitis, celiac disease and lactose or food intolerances can all easily be confused.
Digestive issues that could be signs of IBS—or other conditions—include:
- Abdominal pain
- Bloated or distended abdomen
- Constipation
- Cramps
- Diarrhea
How to Spot IBS Symptoms
While it may seem that all digestive conditions share the same symptoms, that’s not truly the case. “IBS actually has very specific hallmarks,” says Dr. Rizk. “If your doctor asks the right questions about your health history and symptoms, they can usually make a positive diagnosis with just a careful history and focused physical exam, without extensive testing.”
Doctors use a set of guidelines called the Rome criteria to diagnose IBS by looking for abdominal pain or discomfort that:
Meet With A Gastroenterologist
- Comes and goes
- Happens at least a few days a month
- Has been happening for at least six months
- Is accompanied by changes in bowel habits (how often you go or how your stool looks)
Other telltale signs of IBS include abdominal pain or discomfort that worsens or eases around the time of a bowel movement and stool consistency that changes often (sometimes hard or lumpy, sometimes watery).
Red Flags: Warning Signs It Might Not Be IBS
While working toward a diagnosis, your doctor will rule out more serious conditions that can mimic IBS.
“This is where understanding your personal and family health history and ancestry becomes important,” Dr. Rizk says. If your doctor knows you have a family history of celiac disease, IBD or colon cancer, or that your ancestry puts you at higher risk of celiac disease or lactose intolerance, that information can help them avoid a misdiagnosis.
Red flag symptoms that could be signs of a more serious condition include:
- Abdominal pain accompanied by nausea or vomiting
- Bloody diarrhea, painful or painless rectal bleeding, or blood mixed in the stool
- Continuous abdominal bloating (in women, this should trigger a check for ovarian cancer)
- Constant abdominal pain or abdominal pain that isn’t affected by bowel movements
- Waking in the middle of sleep to have a bowel movement
- New onset of diarrhea, diabetes and weight loss after age 40
- Unintentional weight loss
Confirming an Accurate IBS Diagnosis
Questions about your symptoms and triggers are important. But some testing can also help confirm whether your symptoms point to IBS rather than another condition.
“There are several lab tests that help rule out IBS-mimicking conditions,” says Dr. Rizk. “A complete blood count (CBC) and complete metabolic panel (CMP) are a good start.” Depending on your history, your doctor might also do tests that look for markers of celiac disease, inflammation (C-reactive protein) and fecal calprotectin, which measures inflammation in the intestines.
If you have any red flag symptoms, your doctor might recommend additional testing—such as a colonoscopy, an ultrasound of the gallbladder to check for gallstones, a pelvic ultrasound to check the ovaries, or a CT scan of the pancreas or intestine.
If you’re concerned about new or worsening digestive symptoms, it’s always a good idea to talk to your doctor. The sooner you get an accurate diagnosis, the sooner you can start treatment to help you feel better.
Reviewed by Rafat Rizk, M.D., a gastroenterologist who sees patients at Henry Ford Hospital in Detroit.
