IBS - awaiting diagnosis

[MPPP]

In my 50s and have probably had IBS type symptoms for years but not at a significant level, so never seen a GP.

Having had a couple of more severe bouts recently, lasting a few weeks each, including some smears of blood on stools on two occasions earlier in the summer , I went to the GP.

Been through a whole raft of blood and stool tests, results all showing negative on my NHS app but no contact yet from the GP practice. GP had said a colonoscopy was possible but I guess that won’t happen quickly given my test results haven’t shown anything worrying.

Symptoms all seem consistent with IBS, although I haven’t yet identified any triggers other than stress. The only symptom that still worries me is lower backache when I have an attack - not sure if that is consistent with IBS?

I am wondering if there is any other investigation I should push for?

Currently managing this with peppermint oil, Buscopan, Silicolgel whilst I work out food triggers. Any other tips please?

[Luisa22]

Yes, you could ask about Bile Acid Malabsorption (if you get diarrhea) That can sometimes be mistaken for IBS and can be quite easily solved so I hear with a medication.

You can also enquire about SIBO testing (small intestinal bacterial overgrowth) That's a breath test but can take a few hours to do, and there's a strict prep for it. (diet-wise)SIBO can cause either diarrhea or constipation along with other symptoms.

Have you tried doing the Low Fodmap diet trial? I won't ramble on about it here, but google "Low Fodmap Diet". Monash University. Here's a link to their page:

monashfodmap.com/

Or you can also google Low Fodmap Diet for other info.

You could ask your GP for a referral to a dietician. It is possible to do it yourself (I did) but it's a lot of work and research to make sure you won't make yourself more unwell from malnutrition. The re-introduction of high Fodmap foods phase after the 8 week elimination is better if there's a dietician on board.

[MPPP in reply to Luisa22]

Thanks, Luisa, that is all very helpful. I didn’t know about those conditions

[xjrs]

I would await your final results before moving forward, since your treatment might be quite different if you don't have IBS. If you are in the UK, there is a set protocol for diagnosing IBS, so your GP will be carrying out all of the tests that are needed:

nhs.uk/conditions/irritable...

Once you have your final diagnosis, you could try Alflorex probiotic, which has been scientifically studied for IBS. Many people's IBS is due to a gut bacterial imbalance.

This may improve your symptoms greatly once you have adjusted to it.

If you still experience issues after that, ask your GP for a referral to a FODMAP trained dietitian, who will take you through the FODMAP elimination and reintroduction diet. It is important to have as varied a diet as possible with IBS to feed your microbiome. A healthy microbiome can help to keep IBS symptoms at bay. This is why it is better to try Alflorex first before looking at your diet, since you don't want to eliminate foods unnecessarily.

Please note that you might hear a lot about SIBO. This is not as common as people suggest (though some people do have it). Also, the tests for it are inaccurate. You might end up getting misdiagnosed and end up on a brutal regime which will make your health worse. This is what happened to me.

Finally, back pain can be linked to IBS. In fact, that had been my main presenting symptom in recent years. If you have a gut bacterial imbalance, this can oversensitise the nerves in the intestines. Since the intestines are so near other internal organs, this pain can be referred and feel like back pain. Alflorex helped me with this back pain.

[Superzob]

I’m assuming you have IBS-D as you’re trying Silicolgel, in which case peppermint oil might exacerbate it. Other than that, I would go along with what the others have said and hope you find a solution.

[bloated12]

Hi backachecis vindistant with IBS i get it mostly after my evening meal then i have to sit down and wait for it to go away.

[bloated12 in reply to bloated12]

backache is constant

[Luisa22]

I also get lower back pain, but mine came well before any IBS (20 years or more) and according to a chiropractor, I have pelvic misalignment. But whenever anything is wrong with me at all, my back aches more. Including flare ups. Or even if I haven't slept much etc.

[MPPP]

Thanks everyone, some really useful information and I’m reassured that the back ache could be IBS related. The timing does seem to be related to bowel movements but I hadn’t seen it listed as a symptom so I was worried about that.

[jubin in reply to MPPP]

get a colonoscopy done. back pain and inneed of passing a stoll with mucus and blood can indicate a mild ibd or mild proctitis. Im a patient for 13 years and im young and i would like to say see a gastroentorologist surgeon rathen than a GP.

[HowNowWhatNow]

I would push for the colonoscopy in any case. Blood in stool suggests a need.

If you were going privately they would suggest it for these symptoms.

[MPPP]

Have been back to the GP as I have still got back pain, significant problems with gas and some small traces of blood. Been referred for colonoscopy under the 2 week pathway. Having it on my birthday 😬

I’m very scared - it’s been a tough year with my partner having a very serious diagnosis with treatment ongoing. Just seems awful timing that I now have this worry too. I can’t work out what it might be from my symptoms other than cancer. I know I am catastrophising but can’t seem to stop

[MPPP]

All blood tests were normal so I assume that rules out IBD, hence my panic

[MPPP]

Just in case I can offer reassurance to anyone reading this, the colonoscopy prep and the procedure were both tolerable.

Nothing concerning was found so the assumption is that I have IBS. The blood was due to a mucosal prolapse so I need to look to manage that as well