Take 3: Irritable bowel differential diagnosis

Diagnosis of irritable bowel syndrome can usually be made on history alone, says Professor Terry Bolin

Diagnosis of irritable bowel syndrome can usually be made on history alone, says Professor Terry Bolin, the head of gastroenterology at Prince of Wales Hospital.

“Irritable bowel syndrome commonly affects young people, more commonly women than men, and it’s of long duration, so you can usually make the diagnosis on history,” he says.

IBS can be confused with Crohn’s disease of the small intestine when there is no bleeding but there is pain and an altered bowel habit, he says.

IBS is either diarrhoea dominant, constipation dominant, or mixed, and is associated with bloating, pain and urgency of defecation, but never any significant symptom like bleeding.

“[IBS] commonly follows an episode of gastroenteritis,” says Professor Bolin. “It doesn’t matter what the bacteria or virus is; it damages the lining of the bowel, [which] makes it more sensitive.”

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