Hello, fellow Irritable Bowel Syndrome (IBS) warriors and those seeking answers to their digestive troubles. I'm Vanessa Hummel, an Accredited Practising Dietitian (APD) specialising in IBS. It is essential to understand that while IBS is a common disorder of the gut-brain interaction, not all uncomfortable gut symptoms can be attributed to it.
In this blog post, we will dive into some common scenarios where IBS might not be the underlying cause of your digestive symptoms and how to distinguish between IBS and other conditions.
1. Inflammatory Bowel Disease (IBD)
IBD is a group of chronic inflammatory conditions that affect the gastrointestinal tract.
This includes Crohn's disease and ulcerative colitis, which can cause symptoms similar to those of IBS including abdominal pain, bloating diarrhoea and constipation.
These are autoimmune conditions and differentiating factors to IBS include inflammation and structural changes throughout the gut.
There are also diagnostic tests like colonoscopies, biopsies and faecal calprotectin stools tests available to diagnose these.
2. Coeliac Disease
Coeliac disease is an autoimmune condition where the body cannot tolerate gluten, a protein found in wheat, rye, and barley.
People with coeliac disease may experience symptoms such as abdominal pain, bloating and diarrhoea, which are similar to those of IBS.
Diagnosing this condition involves coeliac screening blood tests and endoscopic procedures where biopsies are taken to confirm a diagnosis.
3. Food Allergies or Intolerances
Common food allergies include wheat, dairy, soy, egg and fish and common food intolerances include lactose intolerance and fructose malabsorption.
Both food allergies and intolerance cause symptoms like bloating, nausea, stomach pain and altered bowel habits.
It is important to exclude food allergies as a potential cause of your symptoms as these can cause anaphylaxis. This is a severe allergic reaction that can be fatal. These can be diagnosed using specific allergy tests for IgE antibodies that are conducted by an Allergy Specialist/Immunologist.
Unlike food allergies, food intolerances are not fatal and do not cause any damage throughout your body. This means that there are not tests that can diagnose these and elimination diets will need to be completed under the supervision of an APD.
4. Gastrointestinal Infections
Chronic gastrointestinal bacterial or viral infections can cause symptoms similar to those of IBS including abdominal pain, bloating, and diarrhoea.
These can be ruled out as a potential cause of your symptoms using clinically proven stool tests and a thorough clinical history completed by your medical doctor.
5. Small Intestinal Bacterial Overgrowth (SIBO)
SIBO occurs when there is an overgrowth of bacteria in the small intestine.
This can be due to a number of factors including chronic constipation, gastric bypass surgery and slow gut motility and can lead to symptoms like bloating, gas and diarrhoea, which are also common symptoms experienced by those with IBS.
SIBO can be diagnosed via hydrogen breath tests (although these are not very reliable) and a jejunal aspirate and culture test.
6. Colorectal Cancer
Although rare, colorectal cancer can have similar symptoms to IBS.
Risk factors include family history, age and a low fibre diet.
This is diagnosed via a colonoscopy where biopsies are taken and then tested.
7. Functional Gastrointestinal Disorders (FGIDs)
FGIDs, like functional dyspepsia and functional constipation, share similarities with IBS as IBS is also a FGID.
Accurate diagnosis of these conditions involves using specific diagnostic criteria and the exclusion of other conditions.
8. Psychosocial Factors
Stress, anxiety and depression can amplify digestive symptoms.
Therefore, recognising the role of mental health and its impact on gut health is crucial, and seeking appropriate support is essential.
As an IBS dietitian, my primary goal is to empower you with knowledge and guidance on managing your gut health. However, it is equally important to recognise that IBS may not be the sole explanation for your symptoms. Distinguishing between IBS and other digestive disorders requires a comprehensive assessment by your General Practitioner.
If you suspect your symptoms may not be related to IBS, do not hesitate to seek help. An accurate diagnosis is the first step toward finding effective strategies to alleviate your digestive distress. Together, with the guidance of healthcare providers and dietitians, we can work towards a healthier, happier gut. Remember, you are not alone on this journey, and there are solutions tailored to your unique needs.
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