Irritable Bowel Syndrome (IBS)

Tests & Diagnosis

Are there any tests that I should have?
Sometimes it's a good idea to do a blood test. This can indicate low blood count which indicates anemia and it may reflect bleeding or malabsorption from the gastrointestinal tract. There are other blood tests that let us rule out other diseases like diabetes, abnormal thyroid function or changes in the calcium level that can affect the gastrointestinal tract. There is a blood test for celiac disease that reflects gluten allergy.

Sometimes stool cultures are ordered to rule out infection. Stool samples looking for blood may also be necessary. However, not every patient needs these lab tests and your doctor will order them if they he or she feels it is appropriate.

Some tests allow physicians to see inside the colon and make sure that there is no underlying problem. These include:

• An air contrast barium enema is an x-ray. Before the test, you will be asked to take laxatives to clean out your bowel. At the x-ray facility, barium is introduced through a small tube placed in the anus and rectum. X-rays of the bowel are then taken.
• Virtual colonoscopy involves using a radiological technique to visualize the colon. This can involve either CT or MRI. Computerized reconstructions of the colon are obtained. The patient may require laxatives to clean the bowel out before the x-ray. Air is introduced to open the colon up before x-rays are taken. This technique is primarily used to detect polyps and colon cancer.
• A sigmoidoscopy is another type of scope that visualizes the lower end of the bowel which includes the rectum and sigmoid colon.
• A colonoscopy is where a scope or a flexible tube with a video camera at the end is used to directly visualize the entire colon. The patient is required to take laxatives to clean the bowel out. They may go to the hospital or an outpatient facility where often they may receive intravenous sedation. This is not a general anesthetic. It is called conscious sedation in that the patient is able to breathe by themselves. Often the patients may sleep through the procedure. Some patients actually watch the screen during the procedure.
  In addition to being a more sensitive test than an air contrast barium enema in detecting abnormalities in the colon such as polyps, cancer, ulcerative colitis and Crohn's disease, colonoscopy also allows doctors to obtain biopsies and remove polyps through a technique called snare polypectomy. This technique involves a metal loop wire being placed around a polyp and an electrical current being applied to cut the polyp off and seal the base to prevent bleeding.
  
  

Why would I have these tests done?
These tests allow us to rule out colon cancer, polyps, or inflammatory bowel disease. Not all patients need these tests and your doctor will order them if they feel it is appropriate.