Re: Guidelines for diagnosis
03/11/03 06:14 PM
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Heather
Reged: 12/09/02
Posts: 7799
Loc: Seattle, WA
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Hi there, and welcome to the board. Your symptoms actually do fit those of IBS, and it sounds like you've had a pretty thorough run of diagnostic tests to rule out other disorders.
The degree of abdominal discomfort or pain can vary tremendously from one person to another. Some people feel very little discomfort and have bowel dysfunction as their chief complaint; other people (like me) have pain so severe we black out from it.
Here are the official diagnostic criteria for IBS, known as the Rome II guidelines:
The diagnostic criteria of Irritable Bowel Syndrome always presumes the absence of a structural or biochemical explanation for the symptoms and is made only by a physician. Irritable Bowel Syndrome can be diagnosed based on at least 12 weeks (which need not be consecutive) in the preceding 12 months, of abdominal discomfort or pain that has two out of three of these features:
1. Relieved with defecation; and/or 2. Onset associated with a change in frequency of stool; and/or 3. Onset associated with a change in form (appearance) of stool.
Symptoms that Cumulatively Support the Diagnosis of IBS:
Abnormal stool frequency (may be defined as greater than 3 bowel movements per day and less than 3 bowel movements per week); Abnormal stool form (lumpy/hard or loose/watery stool); Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation); Passage of mucus; Bloating or feeling of abdominal distension.
Supportive Symptoms of IBS:
1. Fewer than three bowel movements a week 2. More than three bowel movements a day 3. Hard or lumpy stools 4. Loose (mushy) or watery stools 5. Straining during a bowel movement 6. Urgency (having to rush to have a bowel movement) 7. Feeling of incomplete bowel movement 8. Passing mucus (white material) during a bowel movement 9. Abdominal fullness, bloating, or swelling
Red Flag symptoms which are NOT typical of IBS:
Pain that often awakens/interferes with sleep Diarrhea that often awakens/interferes with sleep Blood in your stool (visible or occult) Weight loss Fever Abnormal physical examination
I think the food sensitivities you list also dovetail with IBS, as do the symptoms brought on by stress and by the urgency you experience.
I would definitely add in a soluble fiber supplement right away - that will help a great deal. There's detailed info about this at web page And there's lots of other info on the boards.
Please ask any other questions you have - and don't feel like the oddball here with your symptoms. You're certainly not alone in not experiencing severe pain with your IBS. There's a lot of variation here...
Best, Heather
-------------------- Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
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