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Suggest Tests To Diagnose IBS

Posted on Tue, 2 Sep 2014

Question: I have been having an issue with chronic diarrhea for the past 3 months. On some days I may have a more soft but solid bowel movement, but having more per day than usual. The best way to describe the feeling is I get gas high up in my abdominal area that has a slight burning feeling, then the feeling moves down until I have a bowel movement. Then I'm OK for a bit until it starts again. I have had the following tests...colonoscopy, full blood count, liver function tests, hepatic panel, basic metabolic profile, lipid panel, and a full liver/abdominal ultrasound...only abnormality found is a hemangioma. I am not sure the doctor can find an answer to my problem. He has mention IBS but hasn't said it definitively. Is there any other test I should have? I've read that gastrin levels can cause this but anything else he's missing?

Answered by Dr. Rakesh Madhyastha (6 hours later)

Brief Answer:
Irritable bowel syndrome

Detailed Answer:
Hello

Thanks for the query

Your doctor has done an execellent job in getting to a diagnosis. All the relevant investigations are done and they are normal. Hemangioma is of incidental finding and it causes no harm
Irritable bowel syndrome is a disease of exclusion, which means once a doctor can't find anything wrong with the bowel system then a name tag of irritable bowel syndrome is give

However a very close differential diagnosis for IBS is inflammatory bowel disease , I know 3 patients of mine who presented in a similar fashion, I got biopsy of the colon done and it came as IBD, they are on treatment now and are doing very well.

I advise you the same as well, please get a biopsy of the colon , if that turns out to be normal as well then rest assured it is IBS

I hope I was of help, please get back to me for any further queries

Regards

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Rakesh Madhyastha (10 hours later)

Can IBS really cause this burning sensation and diarrhea every day? Seems odd that IBS would start at my age. Is that really possible?

Answered by Dr. Rakesh Madhyastha (21 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello

Thanks for getting back, sorry for the short delay in my reply I was at work at my hospital.

ICS can cause burning and diarrhea everyday. IBS is of two variants, one which causes constipation and the other which causes diarrhea. You seem to be having the diarrhea predominant IBS.

But before tagging you as IBS I strongly recommend that you get a biopsy of the colon done.

I am once again sorry for the short delay in my response.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (3 hours later)

thank you Dr...I should have clarified...the biopsies have been done and came back negative for colitis...but did find out yesterday the ultrasound did find gallstones so he's following up with at CT scan...he said that may be the issue

Answered by Dr. Rakesh Madhyastha (11 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello

Thanks for getting back

Gallstones can explain the distention of abdomen and gas however it cannot explain the diarrhea and burning sensation.

Here are my suggestions for gall stones

1. Eat low fat diet, high fat diet can further worsen the feeling of indigestion
2. Eat smaller meals daily 4-5 times than three heavy meals.
3. Drink atleast 8 glasses of water per day

Please let me know the CT scan result when it comes out.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar