# What should you get tested for before saying it's absolutely IBS?



## Melissa Lady (May 3, 2013)

Hello!

My question is pretty straight forward. I don't have the most normal of IBS symptoms and all I had done was an endoscopy and colonoscopy. My doctor claimed it was IBS before he did any tests and after the procedures he is convinced. I'm still have blood in my stool and my biggest symptom is extreme nausea. I don't have any diarrhea or constipation. I did have some awful pains in my abdomen before the last bit of blood in my stool, but no diarrhea. For about three weeks it was green! With my stupidly strict diet, I've made no changes to cause it :l

My symptoms started a month after I got food poisoning, so that is his reasoning. I've always had severe abdominal cramping. I grew up expecting it at least a few times a year. You know, the kind that makes you cry from the pain. I didn't mention it to my doctor, he shot questions then left.

TL;DR- See question up top


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## Kathleen M. (Nov 16, 1999)

So many doctors just lump in all the functional GI disorders (IBS is not the one and only one) together and just use IBS as the most common of them for all of them rather than giving them all the different names the researchers use or using the more proper generic name functional GI disorder. Since you treat nausea or diarrhea the same no matter which one you have it doesn't really matter much in the clinic if they go through the list of a dozen or so disorders to figure out which one it is.

There are several upper GI functional disorders that have nausea as their major symptom and do not include changes in stool consistency or frequency.

Green stool is actually in the realm of normal. If your bile is green (usually it is either green or yellow) the stool starts off the color of the bile and if it moves faster than the bacteria in the intestines turn it to brown it can come out the original color. You may not have a lot of those bacteria or you could have some issues with motility in the intestines that don't cause full on diarrhea or full on constipation (neither of which is needed for IBS, just a change in consistency or frequency which includes quite a range of issues).

Well the "only tests you had" really do encompass most of the farthest you need to go to get a functional GI illness diagnosis. Those two tests rule out pretty much everything else as they are designed to specifically find the other things (inflammation to the lining of the stomach/duodenum or colon/illeum).

I assume at some point recently you have had a complete blood count which also detects the non-functional reasons for GI illness (also measuring inflammation).

Is the blood in the stool (older darker blood completely mixed in the stool or perhaps only detected with stool sample looking for occult blood) or mostly on the stool and usually bright red? Did they see an internal hemorrhoid during the colonoscopy that would account for the bleeding?

About the only other test I can think of is make sure you had a blood test to screen for celiac disease although extreme nausea and blood with BMs are not the most common symptoms of that.

I know how obnoxious nausea is and how hard to believe it is "just" functional nausea but there often isn't caused by gastritis, GERD or an ulcer.

Do you have issues with dizziness or migraine headaches that could be part of the nausea. Sometimes it is more a central nervous system issue or an inner ear problem than a gut problem as that is the other place nausea can come from.

Are they trying anything to treat it? There are anti-nausea medications out there. Also since it seems to be a problem with the nerves that sense and control the stomach (basically sending nausea signals when they shouldn't) sometimes low dose tricyclic antidepressants can control it. http://www.ncbi.nlm.nih.gov/pubmed/17885700

For what it is worth, food poisoning or other GI infections commonly are the cause of functional GI illnesses, so your doctor is saying that based on evidence, not just making something up. The immune system usually causes some damage to the body while fighting off the infection and the vast neural net that all has to be coordinated and functioning properly for digestion and elimination to occur is particularly sensitive to damage.

If your doctor simply refuses to give any kind of medication or say there cannot possibly be any treatment of any kind at all, find another doctor who will at least give you a few things to try.

Does ginger help you at all, or over the counter motion sickness pills?


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