By: Christopher P. Shaver, MD, Birmingham Gastroenterology Associates
Do you have a bucket list?
A sneak peek at my current bucket list includes a college basketball final four, a Holy Land experience and a kayak trip to the Galapagos Islands. I want to spend a summer touring the United States, in an Airstream trailer.
I checked the Super Bowl off the list 8 years ago. I took my then seven-year old son to Dallas. We watched my beloved Pittsburgh Steelers battle the Green Bay Packers. I splurged on the thing. My premium eBay tickets delivered. We had an absolute blast swinging our terrible towels from the first level corner end zone. But there was a price to be paid. I awoke the morning after the game with a pain shooting down the back of my left leg. Six weeks later, I was in the operating room.
Take home #1: Go to the Super Bowl BUT don’t get in a three-point stance and run violently into a tackling dummy while you are there. My injury was significant. It was painful. My injury was diagnosed with a single test and treated with an outpatient neurosurgery. I haven’t hurt since.
Take home #2. The diagnosis and treatment of IBS is not usually that straight forward. And unlike many other medical problems, there is no single diagnostic test available.
IBS is an extremely common intestinal disorder. Conservatively estimated to affect 10-15% of the population, it has a major impact on the health of millions of people around the world. That is why it is vital that we talk about it and get comfortable with what it is all about. The art of an IBS diagnosis is usually embedded in what we call “the history of present illness.” Here are some diagnostic clues that help me positively diagnose this condition on a regular basis.
1. IBS is chronic. The symptoms of IBS come and go over time but often don’t go away completely. The abdominal pain and bowel habit disturbances are unpredictable and recurrent.
2. IBS lacks alarm symptoms. IBS is occasionally severe and even debilitating to some but lacks alarm symptoms. Alarm symptoms include rectal bleeding, fever, unintentional weight loss, decreased appetite, and unexplained anemia. IBS classically tests normal.
3. IBS is life altering. IBS interrupts normal life as we know it. Those three letters negatively impact work life and compromise social life. They stress relationships. The barrage of normal, repetitive tests often degenerates into feelings of frustration and futility.
The key to an IBS diagnosis is your story. So, get comfortable with it. Put words to it. Share it with your physician. The first step towards IBS control is a confident diagnosis. And the silver lining is that effective, customized treatment plans are available.