Exam Overview

Medical and dietary history

To find out whether
your symptoms meet the
criteria for diagnosing
irritable bowel syndrome (IBS), your doctor may ask
you questions about:

  • Recent stressful events in your life. Stress
    may be a strong indication that your symptoms may be caused by irritable bowel
    syndrome.
  • Bowel function, including how many bowel movements you
    have each day or each week, whether you have constipation or diarrhea, whether
    you have noticed any blood or mucus in your stool, and any recent changes in
    your bowel habits or the shape of your stools.
  • Whether your bowel
    movement patterns have any relationship to your abdominal pain (for example, if
    passing a stool relieves belly pain and cramping).
  • Family history of
    similar symptoms.
  • Family relationships that may be causing
    stress.
  • Your use of laxatives or antacids.
  • Things that
    may increase your risk of an intestinal infection, such as foreign travel,
    drinking untreated water, or recent antibiotic use.

The dietary history will include questions about food
allergies and whether your symptoms seem to be related to any particular foods.
Foods that most commonly cause symptoms include lactose (milk sugar) and
sorbitol, an artificial sweetener found in sugarless chewing gum and other
sugar-free products.

The doctor may suggest that for a period of
time you try avoiding foods that seem to cause problems, to see if your
symptoms get better.

Physical exam

To help find out whether you have
irritable bowel syndrome, the doctor will perform a standard physical
exam, including:

  • Feeling the abdomen.
  • A digital
    rectal exam.
  • Listening for bowel sounds (with a
    stethoscope).
  • A pelvic exam (in women).

Why It Is Done

A medical history and physical
exam are standard tests for people who have belly pain and changes
in bowel habits.

Results

Key findings in IBS are belly pain that
is relieved with a bowel movement and a change in the consistency or number of
times a day or week that you have bowel movements. The pain is not limited to
one part of the abdomen. It may move around and may come and go. It often
occurs or gets worse when you eat. Stress may also be related to belly
pain.

The abdomen may be swollen if you have gas in the
intestines. Your abdomen may be tender when the doctor presses on it. Abnormal
bowel sounds may be heard, especially, but not only, if you have diarrhea. You
may report symptoms such as an urgent need to have bowel movements or a feeling
that you haven’t completely emptied the bowel after you pass a stool.

A person who has IBS may have constipation more often, diarrhea more
often, or constipation that alternates with diarrhea.

All other
physical findings should be normal for a diagnosis of IBS.

What To Think About

Because there is no detectable
structural problem that causes IBS, if you have a normal physical exam but you do have symptoms
of IBS, this strongly suggests that you have irritable bowel syndrome. If your doctor thinks your symptoms may be caused by another problem, he or she may recommend other tests, such as:

  • Blood tests (complete blood count [CBC] and/or
    sedimentation rate), to rule out anemia, inflammation, or
    infection.
  • Test for blood in the stool (fecal occult blood test),
    to check for bleeding in the intestinal tract or white blood cells in the stool
    (a sign of inflammation or infection in the intestines).
  • Tests for
    parasites in the stool, to check whether a parasitic infection, such as
    giardiasis, is causing symptoms.
  • Thyroid
    and liver function tests, to check for metabolic problems.
  • A blood
    test to rule out
    celiac disease.

Your doctor may recommend other tests not in this list. But if there are no symptoms (such as anemia, rectal bleeding
or bloody diarrhea, fever, weight loss, pain that wakes you at night, or recent
change in bowel habits) that suggest other intestinal diseases, few additional
tests are needed. If these symptoms are present, tests for other problems, such
as
inflammatory bowel disease or an ulcer, may be
needed.

Complete the medical test information form (PDF) (What is a PDF document?) to help you prepare for this test.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Adam Husney, MD – Family Medicine

Current as ofMay 5, 2017