Irritable bowel syndrome (IBS): symptoms and ruling out other causes

Irritable bowel syndrome, usually called IBS, is a common condition that affects the digestive system. It can cause tummy pain or cramps, bloating, diarrhoea and constipation. The symptoms can be upsetting and can make daily life hard. This article explains the usual symptoms, the warning signs that need prompt care, and how doctors check that something else is not causing the problem.

What is IBS?

Doctors describe IBS as a disorder of gut-brain interaction. The gut looks normal, but the way it communicates with the brain is disrupted, and this causes problems with how the gut works. The body’s natural stress responses can play a part.

Symptoms often come and go. Flare-ups may be triggered by food or drink. IBS is usually a lifelong condition, but lifestyle changes and medicine can help.

How common is IBS in Bangladesh?

IBS is common in Bangladesh. The figures below come from older community studies. We did not find a more recent national figure.

Two villages in a northern district (published 2001): about 24% of adults had IBS-type symptoms, and about 8.5% met strict Rome diagnostic criteria. Only about 35% of people with IBS had seen a doctor about it.
An urban community in Dhaka (published 2009): a survey of 1,503 people aged 15 and over found that about 7.7% had IBS using the Rome II criteria. About two-thirds (65.5%) of them had sought health care.
Sylhet district (carried out in 2011, published 2018): a survey of 1,900 people found that about 14.2% had IBS using the Rome III criteria.

The numbers differ partly because each study used different diagnostic criteria.

Common symptoms

The main symptoms of IBS are:

Tummy pain or cramps. These are usually worse after eating and better after passing stool.
Bloating. The tummy feels uncomfortably full and swollen.
Diarrhoea. Watery stools, sometimes with a sudden need to go.
Constipation. Straining, or feeling that you cannot empty your bowel fully.

IBS can also cause:

wind (gas)
passing mucus in the stool
tiredness and lack of energy
nausea (feeling sick)
backache
problems passing urine, such as needing to go often, sudden urges to go, or feeling that the bladder has not emptied fully

Some days are better than others. Bad patches, called flare-ups, can last for days, weeks or months at a time.

Warning signs: when to get urgent care

Some symptoms need checking quickly. Ask for an urgent appointment with a doctor, without waiting for a routine visit, if you have:

lost a lot of weight for no reason
bleeding from your bottom, or bloody diarrhoea
a hard lump or swelling in your tummy
shortness of breath, a pounding heartbeat you can feel (palpitations), and skin that is paler than usual

If you are unsure what to do, you can call the government health call centre, Shasthyo Batayon 16263. You can speak to a doctor there, 24 hours a day.

How doctors diagnose IBS and rule out other causes

A doctor can check for IBS and may arrange some tests to rule out other problems.

1. Talking about your symptoms

The doctor will ask:

what symptoms you have
whether they come and go
how often you get them
when you get them, for example after eating certain foods
how long you have had them

IBS may be considered when tummy pain or discomfort gets better after passing stool, or is linked to a change in bowel habit, along with other typical symptoms. These include straining, urgency or feeling the bowel has not emptied, bloating, symptoms that get worse after eating, and passing mucus.

Tip: before your appointment, write down details of your symptoms so you remember them.

2. Physical examination

The doctor may feel your tummy to check for lumps or swelling.

3. Tests

Depending on your symptoms, the doctor may arrange tests to rule out other conditions. Your doctor will decide which tests are right for you.

How IBS is generally managed

IBS is usually a lifelong condition, but lifestyle changes and medicine can help control the symptoms. Because flare-ups may be triggered by food or drink, it can help to note what you eat and how you feel, then talk this over with your doctor. Ask your doctor about any medicine for your symptoms.

Which doctor should you see?

First visit: a general physician (MBBS doctor) or a medicine specialist can check your symptoms and arrange tests to rule out other problems.
Gastroenterologist: a doctor who specialises in the digestive system. See one if your symptoms are severe, do not get better, or come with warning signs.
Paediatrician: for children with ongoing tummy pain or bowel changes.
Psychiatrist or clinical psychologist: if stress, anxiety or low mood seems to be making your symptoms worse.

Key points

IBS is common. It causes tummy pain, bloating, diarrhoea or constipation that come and go.
In IBS the gut looks normal, but the way the gut and brain communicate is disrupted.
A doctor diagnoses IBS mainly from your symptoms and may arrange tests to rule out other problems.
Unexplained weight loss, bleeding from the bottom, a lump in the tummy, or breathlessness with palpitations and pale skin need an urgent appointment.

This article is for general information and does not replace advice from a doctor.

Find a doctor

Browse Gastroenterology doctors in Bangladesh on ratings.com.bd, with chambers and, where listed, visiting hours and phone numbers.

Sources

This article is general information, not medical advice. It was written by AI from the sources above. It did not pass the automatic check, and an administrator chose to publish it; no doctor or editor has reviewed it. For a diagnosis or treatment, see a registered doctor.