Irritable Bowel Syndrome (IBS) and Celiac Disease

We see many patients in the office that present with a label of IBS.  Many of these patients have chronic troubling gastrointestinal symptoms such as diarrhea, constipation and / or abdominal pain.  I am often surprised at how many of these patients have been given a diagnosis of Irritable Bowel Syndrome without a full diagnostic workup.   Some have colonoscopies to make sure they do not have cancer or inflammatory bowel disease.  Many however have not had evaluation of their small bowel as a source of diarrhea or abdominal complaints.  Since IBS is a diagnosis of exclusion, it is imperative that this subset of patients be worked up for organic causation of their symptoms.   The symptoms of IBS  are identical to the symptoms of celiac disease, inflammatory bowel disease (such as Crohns or Ulcerative colitis), small intestinal bacterial overgrowth (SIBO), as well as other functional disorders such as lactose and fructose intolerance. These  remain some of the most overlooked and treatable diagnosis’ to entertain in the “IBS” patient.

As IBS treatment is typically offered for symptom control (as opposed to treating the cause), it is by its very nature a less desirable treatment course. To date a cause of IBS has not been elucidated.  Obviously, if patients truly have this diagnosis our goal is to try various treatment options for successful symptom relief so that we may afford these patients a good quality of life.   Chances of successful treatment however dramatically increase if we can tease out some of the overlooked diseases mentioned above from patients previously thought to have “IBS.”

Gagan Beri MD

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