Irritable Bowel Syndrome that is more commonly abbreviated as IBS, is a diagnosis for a myriad of complaints that patients have that affect their gastrointestinal tract. Patients experiencing IBS, have to be evaluated very closely by their physician to assess if other conditions, or a combinations of conditions might be occuring to cause the IBS. Kenneth Falchuk, MD: Irritable bowel syndrome is the word points to it, is a syndrome, it is a composite of complaints that patients have that effect the GI tract. It is not something that we could immediately say is caused by an infection or is caused by a structural change in the bowel. So therefore the physician who evaluates the patient with irritable bowel syndrome (IBS) has to pay attention to the types of symptoms, when they occur? How frequent is your trigger factor, has to evaluate his patient for the possibility of other conditions and that is where we bring in the criteria of or the characters of what we call reg flags. So irritable bowel syndrome is a combination of symptoms that the patient mentions to the treating evaluating physician that consists of either pain with or without a change in bowel habit such as diarrhea, constipation, or a variable pattern, a mixture of both diarrhea or constipation with bloating with a change in a shape, consistency of they stools, they could be loose, they could be hard, they could be like little fragments. Above all, the irritable bowel does not have the red flags that I mentioned previously, that is the presence of bleeding, very significant relevant weight loss in a short period of time, no fever, and no vomiting, once we consider the red flags and if they are not present in the patient, there are other lab results that we could request to evaluate the patient and exclude something that may be caused by another illness other than the IBS, the irritable bowel. If a physician requests those labs, they are not specific. There is no specific blood test to make the diagnosis of an irritable bowel. So what one does when he looks at the lab for help to see if there is anemia, evidence of bleeding indirectly or directly, a low red cell count, a low iron or something called ferritin, signs of inflammation in the blood. We request a test called Sed rate or CRP that indirectly look at this aspect. Other tests may show low protein to suggest a difficult absorption, nutrition, which is not really a main issue when one deals with irritable bowel. So once the red flags are excluded and that the physician is certain about that, he or she can then say "Well I am not yet sure. I need to evaluate my patient properly." That can be done with x-rays such as CAT scan, x-ray of a small intestine, a barium enema sometimes or proceed to something more specific and definitive, yet somewhat invasive called a colonoscopy where you look at the lining of the colon. You can take samples and make sure there is no inflammation. The bottom-line is to make sure that there is no colitis because colitis is treated differently. It is somewhat of a greater concern to some patients because it could bleed to serious consequences and disabilities, so it is important not to attach diagnosis of IBS, irritable bowel, to someone who may have something that can be treated differently and therefore modify their quality of life and outcome. I think that more or less summarizes what I have been trying to convey about what IBS irritable bowel syndrome is and how to proceed with a detail specific evaluation of this condition. Learn more about Dr. Falchuk: services.bidmc.org/Find_a_doc/doc_detail.asp?sid=41414641434540

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