Doctor has just said I have IBS but no tests done - is this right?

[appledumpling]

While I was pregnant with DD I developed lots of food intolerances and a very sensitive gut. This was 2 years ago and I still can't eat wheat, dairy, soya or yeast without awful cramps, wind, bloating, alternating diarrhoea/constipation etc etc.

Recently I've had pains in my lower left abdomen which are much worse after eating and keep me awake at night sometimes.

I've just seen the doctor and he's prescribed Merbentyl and said I've got IBS.

That's fine if that is the case but I was kind of expecting something else, maybe a colonoscopy perhaps? There is a history of colon problems in the family including colon cancer. I'm not suggesting this is anything as serious as that but shouldn't it be ruled out?

Am I being overconcerned?

I was diagnosed with IBS nearly 3 years ago after suffering similar symptoms no testing, I do get occasional flare ups and the meds work fine.The only bad one I've had since diagnosis was earlier this year I was crippled with pain after my smear although I don't know if it was caused by it.

Thank you borderslass; I'm just fed up with it so hopefully the meds will kick in soon (doc said they can take several weeks to take effect).

appledumpling, GPs give out blanket diagnoses of IBS to anyone who complains of digestive problems because it's easier than running tests and finding out exactly what is causing them.

So I wouldn't accept your GP's diagnosis if I were you. I had terrible 'IBS' about 10 years ago - diarrhoea six times a day, usually straight after eating or drinking, terrible stomach cramps and the GP was useless.

I ended up seeing a nutritionist, who diagnosed not food intolerances, but a digestive system that hadn't recovered from a bout of food poisoning in India two years previously, when my symptoms had first started. I was put on a very basic diet (brown rice, pears and lamb were about all I was allowed to eat) for six weeks, and took lots of probiotic supplements, after which I was able to gradually reintroduce gluten, sugar and dairy products and other meats. My symptoms cleared up and I've been fine ever since.

The thing is, you don't know whether your symptoms, which sound dreadful, are due to an allergy, an intolerance, coeliac disease, food poisoning like mine, or something more sinister. You should see a nutritionist to help you find a diet that alleviates your symptoms, and perhaps even a constructive diagnosis, but you should also go back to your GP and insist on a colonoscopy, especially given your family history.

There is no need for you to suffer as badly as you are, and chucking medication at the problem isn't going to solve it in the long run. The cause needs to be identified so that food becomes your friend again, rather than your enemy.

Nutritionists can arrange stool samples to be checked for parasites which are, aparently, fairly common and can be acquired from something as simple as undercooked pork.
They can then recommend suitable supplements.
I had understood that IBS was only diagnosed when all other illnesses had been ruled out.

IBS = Irritable Bowel Syndrome, a syndrome is just a collection of symptoms that tend to occur together i.e. they don't know the cause. GP's don't really have a clue about it. You could push for a colonoscopy but other wise I would turn to a nutritionist or other type of professional for help.

IBS is normally diagnosable solely through symptoms.

There are disorders which share some of these symptoms but they generally have additional "red flag" pointers which indicate the need for further testing.

The NHS webpage spells this out pretty well.

In addition, I'd be very careful regarding the nutritionist recommendation.
The term nutritionist is not protected so anyone can call themselves one.
There is no standardised qualifications and is often associated with unproven ideas, tests and treatments.

A dietician is the relevant health professional, although I think the diagnosis can be readily made by a G.P. in most instances.

B.A.N.T.

Would that be British Association of Nutritional Therapists?

B.A.N.T. has tried to act like a regulator but really is a practitioner association.

See here, here and here.

So, anyone can still call themselves a nutritionist and B.A.N.T. does not, and can not, offer any effective regulation.

I have been diagnosed with IBS.

Nothing else was ever looked at. I was told it was IBS and that was it. From what I have read since, I thought it was usually done from a process of elimination.

Now my body isn't storing iron, coeliac was looked at but bloods came back clear. I'm convinced it isn't just IBS but it has been a few years now and I have learned to put up with it as since I have had DS it isn't quite as bad.

My doctor asked me to keep a food diary when I was first diagnosed. She asked me if there was any links and I didn't think so but she didn't even bother to have a look at it. I think there is a link with food though.

DBennett, GPs aren't generally interested in finding out why someone has 'IBS' - they just hear diarrhoea, constipation, stomach cramps and bloating, diagnose IBS and prescribe some medication to deal with the symptoms. They are not interested in the causes, so the patient has to find alternative therapists and treatments in order to get relief and a cure.

Of course this can expose some people to quacks and charlatans, but it is possible to find reputable nutritionists/dietitians (call them what you will) - I did and was extremely happy with the advice that I received.

Thankyou ttalloo my nutritionist has an MSc and has been involved in research for a university. She has a foot in both camps, is directed by up to date research but also not constrained by NHS guidelines.

If you have a family history of colon cancer you definitely need to push for further investigation.

I'm shocked that your GP hasn't even countenanced this.

Not that your symptoms are necessarily an indication of anything serious but it is important to screen early for CC.

topsi, what did your nutritionist recommend to you?

She is a work associate, I have a consult booked for Tuesday but not really for IBS though.

As IBS has, by it's very nature, no definitive cause it might unreasonable to suggest your Dr. hunts for one.

It is important to rule out other possible causes but symptom profile has been shown to be just as sensitive as detecting IBS without the cost/risk of tests.

If you have unusual features not representative of IBS there are many tests that could be done.
And should be.

It is also not generally considered that a cure exists for IBS. Symptoms management is the goal although the conditions natural history is to wax and wane over months and years.

And, I will repeat myself, please do not conflate the terms nutritionist and dietician.
See [http://www.bda.uk.com/publications/dietitian-nutritionist2010.pdf here]] for more information.

I do think that some GPs can be guilty of diagnosing IBS for any abdominal discomfort without looking too far into things. Mine insisted that IBS was causing my agonising pain around the time of my period......it turned out (many months, several more doctors and specialists later) that I had pretty serious endometriosis. I'm not suggesting that's what you've got, obviously, appledumpling, but in general I would be wanting to push this a bit further. It's easier and doubtless much cheaper for them to tick the IBS box, give you some pills, and get you out of the surgery asap, rather than order expensive tests and so forth. I'm not usually in favour of people aggressively demanding their 'rights' to free NHS treatment (I'm at that C4 'Hospital' series) but my own experience showed me that sometimes you have to fight your corner. It's your health and you're the one having to live with the discomfort - you need to be sure of what it is and whether the IBS medication is indeed treating it effectively.

IBS is a syndrome - that means a collection of symptoms.

It could be that those symptoms are caused by stress, by inflammation, by loads of things - but it doesn't mean there isn't a cause. Just not a single definitive one as DB says.

If it were me I would not accept IBS as the end of line answer - it's clearly what is happening, but WHY is the important bit.

Saw my nutritionist yesterday, she was great.
We went through lots of things. One thing she did pick up on is that, I like to do juicing in the morning and often add pears. Aparently some people find a certain sugar in pears difficult to digest and she suggested I leave the pears out. I have had antibiotics recently and am a bit IBSy at the moment.
She is also going to go through my supplements and review them for me. I am going to get a full written report and then after a few weeks I will go back for a review.
I think any one with IBS should probably consider seeing someone who has an indepth knowledge of food.

Isn't it odd - I have IBS diagnosed in about 95

I read the NHS page & I only have 2 of the symptoms, I wonder if it is still IBS or if I have controlled my diet/lifestyle so much that I don't get the others

"I think any one with IBS should probably consider seeing someone who has an indepth knowledge of food"

A dietician perhaps...

Sorry for not replying so all these posts; been busy with children etc etc.

Thank you for all the replies. I have already seen a nutritionist (very well qualified) and everything she has suggested has resulted in an improvement in the symptoms. The recent pain has been despite restricting my diet hence the visit to the doctor.

The Merbentyl does seem to be helping. I told the doctor the foods I have trouble with and he didn't seem concerned, just said it was unfortunate I was sensitive to so many things.

What had she suggetsed to you dumpling?

di you get bloating to ?

I cut out wheat, dairy, soya and yeast completely. I alternated oats and quinoa for porridge in the morning and rotated rice/quinoa/gluten free pasta/millet as my carb source in the evening. I also ate fruit separately from my meals i.e. as a snack.

That really helped. I was right as rain in 10 days or so. I had also had joint and muscle pains which had been suspected to be MS but weren't and they all vanished too.

Over time I was able to be a lot more relaxed about rotating the carbs and I was starting to eat a little live yoghurt without an upset tummy afterwards.

Things were fine really until DS gave me a tummy bug over the summer and since then it's been awful again plus I developed this pain in my side hence the visit to the doctor.

GPs know very little in my experience. They're happy to attach labels to people without conducting full investigations.

My GP couldn't even manage to diagnose my cystitis the other day I have now self treated and much better.

If you want futher investigations, then tell the GP that this is what he/she is to arrange for you.