Integrated Services for Managing IBS
Welcome to the IBS clinic for individuals with chronic, nuisance symptoms of abdominal discomfort, gas, fullness, bloating, cramping, altered bowel habits, or things just don’t feel right. Is there a problem with gut flora, intestinal motility, or do you have an ulcer or intestinal inflammation? Could this be something more serious? These are important questions and knowing what is happening in our bodies can be confusing.
Top Conditions Identified
During an IBS Evaluation
- Irritable Bowel Syndrome (IBS)
- Inflammatory Bowel Disease (IBD)
When It’s Time to Come See Us
So why do we highlight IBS in this section? Most individuals are told they have “IBS” long before anyone finally does a serious evaluation to understand the true cause. IBS is a diagnosis that should be given only after thorough testing for other possible causes. Any individual with a history of unusual gastrointestinal symptoms should undergo a medical work up. It is important to remember that inflammatory bowel disease (Crohn’s and Ulcerative Colitis) and Celiac Sprue (gluten allergy) can cause significant harm to the body and can initially appear to be IBS.
Frequently Asked Questions about IBS
Answered by Dr. William Lyday at Gastroenterology Atlanta
IBS stands for irritable bowel syndrome. It is thought to occur in up to 15% of the US population, women more than men and more common in younger adults. There are several official criteria to define IBS, but essentially anyone with intermittent abdominal pain and change in bowel habits may have IBS. Classic IBS consists of symptoms occurring at least once per week for more than 3 months. In many cases IBS may also be associated with food, stress, and anxiety/ depression. It is estimated that up to 40% of individuals with IBS symptoms never seek medical attention.
IBS is a diagnosis of exclusion… meaning that we must rule out several other conditions before we can say a patient has IBS. Typically, anyone who is having significant diarrhea, constipation and pain should have additional testing before a diagnosis of IBS is made.
Typical evaluation of IBS may include –blood laboratory studies, Abdominal Xray or CT scan, Stool studies, Endoscopy – upper and lower evaluation of the gastrointestinal tract using a fiber optic lighted scope.
No, every patient experiences IBS a little differently. There are three major categories
- IBS with diarrhea
- IBS with constipation
- IBS with a mix of both diarrhea and constipation
- Colitis – Crohns or ulcerative colitis
- Celiac Sprue (gluten sensitivity)
- Food Sensitivity
- Bacterial Overgrowth Syndrome (Bad Gut Flora)
- Enzyme deficiency – poor intestinal absorption
- Peptic ulcer
- Less Likely – intestinal cancers
Any patient that reports unexplained worsening abdominal pain, intestinal bleeding, weight loss or a sudden escalation in symptoms should be seen by their doctor. These warning symptoms may mean there is an alternative diagnosis and not just IBS.
The feelings of abdominal pain, cramping and altered bowel habits can certainly be improved or eliminated. “Cured” is probably not the right word. “Controlled” through diet, lifestyle and medical management is certainly achievable. The key is to be very thorough and investigate all of the potential causes. Getting better may take time and requires consistent changes in diet, lifestyle and avoidance of trigger foods and activities. You should plan to have regular follow up with the doctor, dietitian until symptoms have been significantly improved.
Usually not. Again, in order to make the diagnosis of IBS, we must rule out several other conditions. If lab work, Xrays, endoscopy are all normal it is unlikely that you have a condition that is going to harm you.
There is a strong correlation between IBS symptoms and stress, anxiety, and depression. How these factors interplay is not clear. Much research has centered on the brain –gut axis and serotonin receptors which are found in both the brain and the intestinal tract. Serotonin receptor blockers are a category of antidepressant that is often used in treating IBS when all else is failing. There are also other categories of antidepressants which can be helpful in IBS when diet and lifestyle changes aren’t working.
In some cases, bad bacteria in the intestinal tract can mimic symptoms of IBS – gas, bloating, pain and altered bowel habits. When we say “bad bacteria”, we really mean there is a bacterial species living in the intestinal tract that shouldn’t be there. To diagnose this condition, we typically use a Hydrogen Breath Test. The patient with suspected bad flora, will drink a glucose/ lactose solution and multiple measurements of breath hydrogen are taken over the next few hours. Normal gut flora does not produce much hydrogen; bad bacteria produces a lot of hydrogen which can be detected by this breath testing. If the breath test is positive, an antibiotic is prescribed to eradicate the bad bacteria.
Remember IBS is a diagnosis that is only made after a thorough medical evaluation. We recommend that before experimenting with vitamins and supplements, be sure there is nothing more serious occurring in the body. Always see the doctor first.
IBD or Celiac Disease?
Identify the Problem Early and Get Treated
In the early stages, IBD and Celiac disease cause mild abdominal pain, food intolerance, gas/bloating, chronic diarrhea or constipation. Over time, both conditions lead to increased symptoms, poor quality of life, disability due to pain and fatigue, hospitalizations, intestinal surgeries, malnutrition, arthritis, joint pain, weight fluctuation and even intestinal cancer. Fortunately, most of the disastrous consequences of IBD and Celiac can be prevented through good medical management. The key is to identify the problem early and get treated.
If you experience any of the symptoms above, it is time to come see our team at Gastroenterology Atlanta. Click the button below to schedule your appointment with one of our experts.
OUR PATIENTS SAY
"Throughout our interactions with him as well as his office staff...what a pleasant experience! Not to mention his great personality as well."
Dr. Lyday and his team are super helpful and nice. The facility is also a very comfortable place to go for treatment.
Great bedside. Seems determined to find and solve what the issues were.
Dr. Lyday is very professional and detailed. You can tell he cares about you and has great knowledge . Nice people.