Are Your Digestion Troubles Irritable Bowel Syndrome?

Some conditions can be hard to diagnose, especially if they have a wide range of symptoms that show up in different ways. Irritable bowel syndrome, or IBS, is one of those tricky conditions that have a number of symptoms similar to other abdominal issues, many of which can be quite serious.  

“Diagnosing IBS can be difficult because symptoms are the same as many other digestive diseases,” says gastroenterologist Brian Baggott, MD.

Because it’s difficult to diagnose, it’s important you see a trusted healthcare provider to get a correct diagnosis if you start showing signs and symptoms of IBS or other abdominal issues. Dr. Baggott breaks down the symptoms of IBS you should watch out for, as well as other symptoms often associated with other conditions. 

Symptoms of IBS 

IBS is generally associated with discomfort in your abdominal area. This can be triggered by stress or worsen after eating.

Signs of IBS include abdominal pain on average of one day a week over the course of three months, and it’s usually associated with two or more of the following: 

• Prolonged belly pain, bloating, cramping or excess gas. 
• Changes in bowel frequency — either an increase in bathroom emergencies or a decrease in bathroom activity. 
• Changes in stool shape and size — it can be watery, hard or contain mucous. 
• Diarrhea, constipation or a combination of both. 

“IBS is a real disease that has real treatments that can significantly improve your quality of life,” says Dr. Baggott. 

Some common symptoms that aren’t associated with IBS include: 

• Excessive, sudden weight loss. 
• Intestinal bleeding or blood in your stool. 
• Constant and severe bouts of pain that set on suddenly. 
• Fever. 
• Unexplained iron deficiency anemia.
• Swollen abdominal masses or lymph nodes.
• Onset of symptoms after the age of 50.

Treatment for IBS can range from adjusting your diet to getting prescriptions for antispasmodics, which help with the cramping pain that accompanies the condition. While it’s important to identify the symptoms you’re experiencing, it’s also important you don’t rely on self-diagnosis. If any of these symptoms occur, you should see your healthcare provider because you could have a different diagnosis than IBS.

Is it IBS or something else? 

Abdominal pain, changes in bowel movement and stool changes can be associated with a variety of conditions, including the following: 

Inflammatory bowel disease (IBD) 

Inflammatory bowel disease may sound like IBS, but it’s quite different. IBS doesn’t cause damage to your intestines. IBD is a group of disorders that cause chronic inflammation, pain and swelling in your intestines. This can happen in response to genetics, environmental factors and your body’s immune system response. The most common forms of IBD are Crohn’s disease and ulcerative colitis. 

Crohn’s disease can cause pain and swelling anywhere along your digestive tract — from your mouth to your anus. This is a lifelong condition that includes the following symptoms: 

• Abdominal pain. 
• Chronic diarrhea. 
• Fever. 
• Loss of appetite. 
• Weight loss. 
• Abnormal skin tags. 
• Anal fistulas. 
• Rectal bleeding. 

Ulcerative colitis causes irritation and ulcers to form in your large intestine. Symptoms can include: 

• Severe abdominal pain or cramping. 
• Diarrhea or urgent bowel movements. 
• Fatigue. 
• Nausea. 
• Weight loss. 
• Anemia (reduced number of red blood cells). 
• Fever. 
• Skin rashes. 
• Mouth sores. 
• Joint pain.

“Bloody diarrhea is not IBS,” stresses Dr. Baggott. 

Celiac disease 

This digestive and multisystem disorder is triggered when affected people eat gluten (a protein in some grains like wheat, barley and rye). When you have celiac disease and you eat foods that contain gluten, you develop intestinal swelling and inflammation. Some people with celiac disease show no signs or symptoms, while others could experience: 

• Abdominal pain. 
• Excessive gas and bloating. 
• Weight loss. 
• Mouth sores. 
• Anemia. 
• Joint pain. 
• Nerve damage. 
• Depression. 

“Celiac disease is very common and it’s become part of the initial workup for IBS,” notes Dr. Baggott. “There are a few tests you can do, one of which is a blood test for celiac disease.” 

Diverticulosis 

Diverticulosis happens in most adults. In response to an increase in pressure over time, diverticula, or expanded pockets or bubbles, can form in the wall of your colon (similar to the bulges that can form when you put too much air in a bike tire). On their own, these pockets don’t need to be treated and don’t cause any signs or symptoms. But over time, they can become inflamed or infected, which is called diverticulitis. If you have diverticulitis, you may show symptoms that include: 

• Concentrated, sharp pain in your lower left abdomen. 
• Fever. 
• Nausea and vomiting. 
• Chills. 
• Cramping. 
• Constipation or diarrhea. 
• Rectal bleeding. 

Endometriosis 

Endometriosis shares many symptoms with IBS, most notably abdominal and pelvic pain. Endometriosis occurs when tissue similar to the lining in your uterus (endometrial tissue) attaches to other structures in your abdomen or pelvis. Symptoms of endometriosis can include: 

• Painful menstrual cramps. 
• Abdominal cramps or back pain during menstruation. 
• Painful bowel movements. 
• Painful sex. 

“Generally, your pain will intensify before you get your period and it goes away after you have your period,” explains Dr. Baggott. 

Dyspepsia 

Dyspepsia, or indigestion, is a condition that describes an upset stomach. This is generally accompanied by a painful or burning feeling in your abdomen. It’s often confused for heartburn, which happens when stomach acid splashes against your esophagus. Indigestion itself can be a sign of several conditions, including IBS. But if you have chronic indigestion, you may have what’s called functional dyspepsia. 

“With functional dyspepsia, people who experience heartburn don’t respond to acid suppression,” says Dr. Baggott. “If you have acid reflux causing heartburn, it’s going to get better when you suppress the acid buildup.” 

Lactose intolerance 

This condition describes someone’s inability to digest lactose, a specific sugar found most often in milk and dairy products. This condition is typically accompanied by bloating, discomfort and diarrhea after ingesting lactose products. 

“It can seem similar to IBS, but a dietary trial of removing lactose-containing products from your diet to see if you get better can be helpful to determine the difference,” says Dr. Baggott. 

Cancer 

Diagnostic tests are very important in ruling this out. While early colorectal cancer can show no symptoms, knowing your family history and getting screened for colorectal cancer is critical. Signs you should see your healthcare provider include weight loss, rectal bleeding and bloody stool. 

The bottom line 

If you experience any bleeding or sudden weight loss, you should see your doctor immediately.

If you’re experiencing symptoms of IBS over the course of three months, you should also seek out a diagnosis from your healthcare provider.

“If your history raises red flags like bleeding or weight loss, you have to really act on that and not assume it’s IBS,” cautions Dr. Baggott.