Updated: Apr 19, 2020
I hear this story time and time again from my clients, and have even experienced it myself:
You suffer from daily digestive issues that are very disruptive to your life, and nothing you do seems to make it better. So, you go to your doctor, who then runs some tests (if you're lucky), all of which come back "normal". the doc then calls to tell you that there's nothing wrong, "it's just IBS".
In this blog, I will discuss why it's important to keep looking for answers beyond an IBS diagnosis.
What does an IBS diagnosis actually mean?
In my experience working with people who have just received an IBS diagnosis, very few know what it actually means. IBS is technically defined by the Rome IV criteria, established for research purposes but also often used in clinical practice:
Recurrent abdominal pain, on average, at least 1 day per week in the last 3 months, associated with 2 or more of the following criteria: – Related to defecation – Associated with a change in frequency of stool – Associated with a change in form (appearance) of stool Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis
Considering how broad and nonspecific the criteria is, it’s no surprise that in Western countries, including New Zealand and Australia, approximately 10% of the general population fulfills the Rome IV criteria for IBS.
Certain red flag symptoms such as gastrointestinal bleeding, unexplained weight loss, and age were selected to be used as referral guidelines for further medical testing (e.g. colonoscopy) to rule out colon cancer and inflammatory bowel disease. Meaning everything else was left on the table and lumped into IBS.
IBS is then generally treated with laxatives, antidiarrheals, proton pump inhibitors, and in some cases, a low FODMAP diet.
The problem with this is that although these treatments may help to reduce symptoms in the short-term, we now know that they actually contribute to further gut dysfunction in the long-term, and it doesn't address the real root cause.
The fact is, when the IBS diagnostic/treatment system came out, we knew very little about the gut, particularly the gut microbiome, which we now know plays a profound role in our health and longevity. Thanks to these recent scientific advances, we can now identify and treat many gastrointestinal disorders, triggers and imbalances responsible for IBS symptoms.
WHY DOESN'T MY DOCTOR LOOK FURTHER?
You may be wondering, well hang on, my Doctor spend years in medical school, why don't they dig deeper? There are a couple of different reasons for this. Firstly, modern medicine is designed to treat symptoms, not find and treat the underlying cause (unless life threatening). Secondly, 'Gut Health' is a whole new world, and many Doctors simply do not keep up with all the latest research. Conditions like SIBO are certainly becoming more recognised as an underlying cause for IBS symptoms, but testing and treatment is still not considered "standard practice", so unless your Doctor is an expert in the field, their knowledge is likely to be limited.