Irritable Bowel Syndrome: Should I Have Tests for IBS Symptoms?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Irritable Bowel Syndrome: Should I Have Tests for IBS Symptoms?

1

Get the
Facts

2

Compare
Options

3

Your
Feelings

4

Your
Decision

5

Quiz
Yourself

6

Your Summary

Get the facts

Your options

Accept your doctor's diagnosis of irritable bowel syndrome. Try home treatment. If it helps your symptoms, you may feel reassured that you have IBS rather than another problem.
Have tests to make sure that you don't have a more serious problem.

Key points to remember

There are no tests that can diagnose irritable bowel syndrome (IBS). Instead, experts use a set of criteria that help your doctor decide whether you have IBS. Your doctor probably will ask you a lot of questions about your symptoms to see how well your symptoms match these criteria.
If your symptoms get better with home care and changes to your diet, you likely have IBS and don't need tests for other digestive problems. If your symptoms don't get better, your doctor probably will want you to have some tests.
If you have IBS, your test results for other digestive problems will be normal. An abnormal test result may mean that you have a problem other than IBS.
If your tests are all normal and your symptoms match the symptoms common in people with IBS, you probably don't have a serious problem. You and your doctor can then focus on relieving your symptoms so that they don't interfere with your life.
When deciding whether to have tests, weigh the chance that you may have a more serious problem against the risks, discomfort, and costs of tests.
If any of the following apply to you, your doctor probably will want to do tests to make sure that you don't have a more serious problem:
- You are older than 50.
- You have blood or pus in your stool.
- Your symptoms have come on quickly over the past few weeks to months.
- You have had unexplained weight loss, fever, or diarrhea at night.
- Your pain wakes you up at night.

FAQs

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (IBS) is a common digestive problem. Many people have symptoms of IBS (such as diarrhea, constipation, bloating, and belly pain) and never see a doctor about them. Other people may choose to see a doctor because they are concerned about their symptoms or because the symptoms are affecting their life.

It is not clear what causes irritable bowel syndrome, and the cause may be different for different people. Some ideas about what causes IBS include problems with the way signals are sent between the brain and the digestive tract, problems digesting certain foods, and stress or anxiety. People with IBS may have unusually sensitive intestines or problems with the way the muscles of the intestines move.

There are no tests that can diagnose IBS. Instead, experts use a set of criteria that help your doctor decide whether you may have IBS. Your doctor will likely ask you a lot of questions about your symptoms to see how well your symptoms match these criteria.

Treating the symptoms of IBS can improve your quality of life. But even with good treatment, you may still have some symptoms.

What tests would you have for your symptoms?

If you have tests, your doctor will decide which ones to do based in part on which symptoms bother you the most.

At your first visit, your doctor may recommend some of these tests:

Medical history and physical examination
A blood test for celiac disease. Many doctors do this test, because the symptoms of IBS and celiac disease can be the same.
Tests for lactose intolerance. Taking a breath test or trying a lactose-free diet may show that you have trouble digesting lactose.
Blood tests. They can show an illness or infection.
Stool analysis, which may include testing for blood in the stool (fecal occult blood test), infection (stool culture), or parasites (ova and parasites test)

Your doctor may also recommend other tests not in this list, such flexible sigmoidoscopy or colonoscopy. Whether you have tests before you try home treatment may depend on your age and health history and which tests your doctor uses the most.

If you have an abnormal test result, it may mean that you have a problem other than IBS. You also may have both IBS and another problem.

How can you treat IBS symptoms at home?

Treatment usually includes making changes to your diet and lifestyle. You may try to:

Increase the fibre in your diet. Try to eat more fresh fruits (such as raspberries, pears, and apples) and fresh vegetables (such as carrots and spinach). Also try to eat more whole-grain breads and cereals.
Avoid or limit gas-producing foods or drinks. These include beans and cabbage, sugar-free chewing gum and candy, caffeine, and alcohol.
Lower stress.
- Get regular exercise.
- Keep a journal or diary of events in your life to try to find a link between stress and your symptoms.
- Enjoy hobbies and other activities to help you relax.
- Get counselling if you need help to lower your stress.

What can you do with the information you get from tests?

If your tests are all normal and your symptoms match the symptoms that are common in people with IBS, you may feel reassured that you don't have a serious problem. You and your doctor can then focus on treating your symptoms so that they don't interfere with your life.

If the tests find that you have another problem, you and your doctor will make a plan to treat it.

What new problems could develop if you have tests?

Most tests have some risks. But the chance of a serious problem from a test is low.

Some of the tests, such as flexible sigmoidoscopy or colonoscopy, may be uncomfortable. People with IBS may find these tests more uncomfortable than do people who don't have IBS.

What are the risks of not having tests?

There is usually little risk in not having tests if your symptoms match those of IBS. The more of these symptoms you have, the more likely it is that you have IBS.

If you have a more serious problem, your symptoms are likely to get worse.

"Alarm symptoms" also may show that you have a more serious problem. These symptoms include:

A fever.
Unexplained weight loss.
Blood in your stools.
Anemia.

If you have any of these alarm symptoms, or if your symptoms get worse, your doctor will probably recommend tests. If you have a family history of colon cancer or inflammatory bowel disease, your doctor will probably recommend tests.

Why might your doctor recommend tests for IBS symptoms?

Your doctor might recommend tests if:

Your symptoms are getting worse.
Your symptoms have come on quickly over the past few weeks to months.
Your symptoms don't match those of most people who have IBS.
You are older than 50.
You have blood or pus in your stool.
You have alarm symptoms, such as unexplained weight loss, fever, or diarrhea at night.
Your pain often wakes you up at night.

Compare your options

Compare


What is usually involved?
What are the benefits?
What are the risks and side effects?

Have tests for IBS symptoms Have tests for IBS symptoms

You follow your doctor's directions for getting ready for the test.

If the tests find nothing wrong, it's likely that you have IBS.
Knowing that you don't have a serious problem may give you peace of mind.
If the test finds something wrong, you can start treating it.

Tests can be uncomfortable.

Don't have tests Don't have tests

You treat symptoms at home. You avoid foods that make your symptoms worse. You also can try to reduce stress.
If home treatment doesn't relieve your symptoms, you can decide to have tests.

Home care might relieve or get rid of your symptoms.
If home care helps your symptoms, you can be reassured that you don't have a serious problem.
You avoid the discomfort and costs of testing.

Home care might not completely relieve your symptoms.
You may not know for sure whether you have a serious problem.

Personal stories about having tests for irritable bowel syndrome

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I have had a "nervous stomach" since I was in grade school. When I had to take a big test, or when I was nervous about something, I would always get stomach cramps and diarrhea. Recently, I took a new job in a new city. It seems like I have had diarrhea ever since I started this job. I went to see my doctor about it because I was getting a little concerned. She asked me a lot of questions and did some blood tests. She said it seemed very likely that I have irritable bowel syndrome, and she said that it would be reasonable to do more tests, but she didn't feel it was truly needed. I felt a lot better after talking to her, so we agreed that I would wait another month or so to see what happens. Then we will talk again and see if I am still having symptoms before we decide about more tests.

Janna, age 35

I became nervous about my bowel symptoms when a friend of mine was diagnosed with colon cancer. I don't know what symptoms she was having, but it got me very concerned. I went to my doctor, and he did a thorough examination and asked me a lot of questions. He said that my symptoms were very similar to those of people who have irritable bowel syndrome. I asked him how he could be sure without doing any tests. He said that he couldn't be absolutely sure, but that he was confident that I didn't have anything more serious. I told him that I really was concerned, and that I would feel better if we did some tests. So I am doing some home treatment and going in next week for some tests. Even if they don't show anything, I know that I will rest easier.

Teresa, age 29

At my last doctor visit, we talked about my symptoms of cramps, bloating, and constipation. I've had these symptoms for about the last 20 years. My doctor reminded me that sometimes constipation can be a symptom of colon cancer and suggested that we talk about whether I should have a colonoscopy. Since I have had my symptoms for so long, we agreed to try increasing the fibre in my diet and to talk again in a few more weeks. I'm not too worried, because I have had these symptoms for so long.

Daniel, age 45

My doctor diagnosed me with irritable bowel syndrome at my last visit. But I can't stop wondering if there isn't something more seriously wrong with me. I have been doing all the things that are supposed to help my symptoms, but they are still there, although they are definitely better. I am going to ask my doctor if it is reasonable for me to have more tests to find out whether there might be something else going on.

Marcie, age 37

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have tests for IBS symptoms

Reasons not to have tests

Even if home care helps my symptoms, I'll worry that I have something serious.

If home care helps my symptoms, I won't worry that I have something serious.

More important

Equally important

More important

I don't want to wait and see if home care gets rid of my symptoms.

I want to give home care a chance to relieve my symptoms.

More important

Equally important

More important

I don't mind if the tests are a little uncomfortable.

I don't want to have tests that could be uncomfortable unless I have to.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having tests

NOT having tests

Leaning toward

Undecided

Leaning toward

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

What matters to you

Print Summary

Credits

Author	Healthwise Staff
Primary Medical Reviewer	E. Gregory Thompson MD - Internal Medicine
Primary Medical Reviewer	Brian D. O'Brien MD - Internal Medicine
Primary Medical Reviewer	Adam Husney MD - Family Medicine
Primary Medical Reviewer	Arvydas D. Vanagunas MD - Gastroenterology

Irritable Bowel Syndrome: Should I Have Tests for IBS Symptoms?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the Facts

Your options

Accept your doctor's diagnosis of irritable bowel syndrome. Try home treatment. If it helps your symptoms, you may feel reassured that you have IBS rather than another problem.
Have tests to make sure that you don't have a more serious problem.

Key points to remember

There are no tests that can diagnose irritable bowel syndrome (IBS). Instead, experts use a set of criteria that help your doctor decide whether you have IBS. Your doctor probably will ask you a lot of questions about your symptoms to see how well your symptoms match these criteria.
If your symptoms get better with home care and changes to your diet, you likely have IBS and don't need tests for other digestive problems. If your symptoms don't get better, your doctor probably will want you to have some tests.
If you have IBS, your test results for other digestive problems will be normal. An abnormal test result may mean that you have a problem other than IBS.
If your tests are all normal and your symptoms match the symptoms common in people with IBS, you probably don't have a serious problem. You and your doctor can then focus on relieving your symptoms so that they don't interfere with your life.
When deciding whether to have tests, weigh the chance that you may have a more serious problem against the risks, discomfort, and costs of tests.
If any of the following apply to you, your doctor probably will want to do tests to make sure that you don't have a more serious problem:
- You are older than 50.
- You have blood or pus in your stool.
- Your symptoms have come on quickly over the past few weeks to months.
- You have had unexplained weight loss, fever, or diarrhea at night.
- Your pain wakes you up at night.

FAQs

What is irritable bowel syndrome (IBS)?

It is not clear what causes irritable bowel syndrome, and the cause may be different for different people. Some ideas about what causes IBS include problems with the way signals are sent between the brain and the digestive tract , problems digesting certain foods, and stress or anxiety. People with IBS may have unusually sensitive intestines or problems with the way the muscles of the intestines move.

Treating the symptoms of IBS can improve your quality of life. But even with good treatment, you may still have some symptoms.

What tests would you have for your symptoms?

If you have tests, your doctor will decide which ones to do based in part on which symptoms bother you the most.

At your first visit, your doctor may recommend some of these tests:

Medical history and physical examination
A blood test for celiac disease. Many doctors do this test, because the symptoms of IBS and celiac disease can be the same.
Tests for lactose intolerance. Taking a breath test or trying a lactose-free diet may show that you have trouble digesting lactose.
Blood tests. They can show an illness or infection.
Stool analysis, which may include testing for blood in the stool (fecal occult blood test), infection (stool culture), or parasites (ova and parasites test)

If you have an abnormal test result, it may mean that you have a problem other than IBS. You also may have both IBS and another problem.

How can you treat IBS symptoms at home?

Treatment usually includes making changes to your diet and lifestyle. You may try to:

Increase the fibre in your diet. Try to eat more fresh fruits (such as raspberries, pears, and apples) and fresh vegetables (such as carrots and spinach). Also try to eat more whole-grain breads and cereals.
Avoid or limit gas-producing foods or drinks. These include beans and cabbage, sugar-free chewing gum and candy, caffeine, and alcohol.
Lower stress.
- Get regular exercise.
- Keep a journal or diary of events in your life to try to find a link between stress and your symptoms.
- Enjoy hobbies and other activities to help you relax.
- Get counselling if you need help to lower your stress.

What can you do with the information you get from tests?

If the tests find that you have another problem, you and your doctor will make a plan to treat it.

What new problems could develop if you have tests?

Most tests have some risks. But the chance of a serious problem from a test is low.

Some of the tests, such as flexible sigmoidoscopy or colonoscopy, may be uncomfortable. People with IBS may find these tests more uncomfortable than do people who don't have IBS.

What are the risks of not having tests?

There is usually little risk in not having tests if your symptoms match those of IBS. The more of these symptoms you have, the more likely it is that you have IBS.

If you have a more serious problem, your symptoms are likely to get worse.

"Alarm symptoms" also may show that you have a more serious problem. These symptoms include:

A fever.
Unexplained weight loss.
Blood in your stools.
Anemia.

Why might your doctor recommend tests for IBS symptoms?

Your doctor might recommend tests if:

Your symptoms are getting worse.
Your symptoms have come on quickly over the past few weeks to months.
Your symptoms don't match those of most people who have IBS.
You are older than 50.
You have blood or pus in your stool.
You have alarm symptoms, such as unexplained weight loss, fever, or diarrhea at night.
Your pain often wakes you up at night.

2. Compare your options

	Have tests for IBS symptoms	Don't have tests
What is usually involved?	You follow your doctor's directions for getting ready for the test.	You treat symptoms at home. You avoid foods that make your symptoms worse. You also can try to reduce stress. If home treatment doesn't relieve your symptoms, you can decide to have tests.
What are the benefits?	If the tests find nothing wrong, it's likely that you have IBS. Knowing that you don't have a serious problem may give you peace of mind. If the test finds something wrong, you can start treating it.	Home care might relieve or get rid of your symptoms. If home care helps your symptoms, you can be reassured that you don't have a serious problem. You avoid the discomfort and costs of testing.
What are the risks and side effects?	Tests can be uncomfortable.	Home care might not completely relieve your symptoms. You may not know for sure whether you have a serious problem.

Personal stories

Personal stories about having tests for irritable bowel syndrome

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I have had a "nervous stomach" since I was in grade school. When I had to take a big test, or when I was nervous about something, I would always get stomach cramps and diarrhea. Recently, I took a new job in a new city. It seems like I have had diarrhea ever since I started this job. I went to see my doctor about it because I was getting a little concerned. She asked me a lot of questions and did some blood tests. She said it seemed very likely that I have irritable bowel syndrome, and she said that it would be reasonable to do more tests, but she didn't feel it was truly needed. I felt a lot better after talking to her, so we agreed that I would wait another month or so to see what happens. Then we will talk again and see if I am still having symptoms before we decide about more tests."

— Janna, age 35

"I became nervous about my bowel symptoms when a friend of mine was diagnosed with colon cancer. I don't know what symptoms she was having, but it got me very concerned. I went to my doctor, and he did a thorough examination and asked me a lot of questions. He said that my symptoms were very similar to those of people who have irritable bowel syndrome. I asked him how he could be sure without doing any tests. He said that he couldn't be absolutely sure, but that he was confident that I didn't have anything more serious. I told him that I really was concerned, and that I would feel better if we did some tests. So I am doing some home treatment and going in next week for some tests. Even if they don't show anything, I know that I will rest easier."

— Teresa, age 29

"At my last doctor visit, we talked about my symptoms of cramps, bloating, and constipation. I've had these symptoms for about the last 20 years. My doctor reminded me that sometimes constipation can be a symptom of colon cancer and suggested that we talk about whether I should have a colonoscopy. Since I have had my symptoms for so long, we agreed to try increasing the fibre in my diet and to talk again in a few more weeks. I'm not too worried, because I have had these symptoms for so long."

— Daniel, age 45

"My doctor diagnosed me with irritable bowel syndrome at my last visit. But I can't stop wondering if there isn't something more seriously wrong with me. I have been doing all the things that are supposed to help my symptoms, but they are still there, although they are definitely better. I am going to ask my doctor if it is reasonable for me to have more tests to find out whether there might be something else going on."

— Marcie, age 37

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have tests for IBS symptoms

Reasons not to have tests

Even if home care helps my symptoms, I'll worry that I have something serious.

If home care helps my symptoms, I won't worry that I have something serious.

More important

Equally important

More important

I don't want to wait and see if home care gets rid of my symptoms.

I want to give home care a chance to relieve my symptoms.

More important

Equally important

More important

I don't mind if the tests are a little uncomfortable.

I don't want to have tests that could be uncomfortable unless I have to.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having tests

NOT having tests

Leaning toward

Undecided

Leaning toward

Credits

By	Healthwise Staff
Primary Medical Reviewer	E. Gregory Thompson MD - Internal Medicine
Primary Medical Reviewer	Brian D. O'Brien MD - Internal Medicine
Primary Medical Reviewer	Adam Husney MD - Family Medicine
Primary Medical Reviewer	Arvydas D. Vanagunas MD - Gastroenterology

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