Common IBS symptoms that could be ‘red flags’ for serious illnesses

In a recent episode of the ZOE Shorts podcasts, gastroenterologist Dr Will Bulsiewicz shed light on the potential health risks associated with misdiagnosing irritable bowel syndrome (IBS). He cautioned that attributing underlying symptoms solely to IBS, without considering other possibilities, could have serious consequences.

During the podcast, Dr Will engaged in a conversation with CEO Jonathan Wolf, delving into the nuances of IBS, its four different types, and the diagnostic process. He explained the term “mucous colitis” was coined by Sir William Osler, a prominent physician of his time, back in 1892.

This description referred to a digestive condition characterised by abdominal pain and the presence of mucus in the stool. Over time, this condition came to be recognised as the early definition of IBS.

Dr Will went on to discuss the four distinct types of IBS: IBS-D (diarrhoea-predominant), IBS-C (constipation-predominant), IBS-M (mixed), and the rare IBS-U (unclassified). Each type is characterised by specific bowel movement patterns and symptoms. However, it is important to note experiencing pain, diarrhoea, or constipation does not automatically indicate IBS. It is crucial to explore all possible avenues before reaching a conclusion.

He said: “One of the important things from my perspective as a medical doctor is to make sure that you’re not missing something else.

“There are a number of different conditions that can masquerade and sound just like IBS, and yet if it’s something else, you’re not treating your patient appropriately until you make that diagnosis and then target that in terms of your treatment.

“So one of the things that doctors will do is they’ll look for red flag symptoms, and this helps the doctor to realise that there may be something more going on here beyond just run-of-the-mill irritable bowel syndrome.”

According to Dr Will, some red flag symptoms that may accompany common signs of IBS include:

• Unexplained weight loss
• Anaemia
• Blood in the stool
• Experiencing night-time diarrhoea
• Progressive or intensifying abdominal pain.

Additionally, doctors should exercise extra caution when patients are over the age of 50 or have a family history of inflammatory bowel disease or bowel cancer, as these factors warrant further investigation.

Dr Will highlighted several other conditions which could be characterised by IBS-like symptoms, including chronic infections such as Clostridium difficile infection or giardia. He also mentioned coeliac disease, food intolerances like lactose intolerance or FODMAP intolerance, small intestine bacterial overgrowth (SIBO), and inflammatory bowel diseases like ulcerative colitis, Crohn’s disease, or microscopic colitis.

If you are concerned about any symptoms you may be experiencing, it is crucial to seek medical attention from your doctor. Additionally, you can visit the ZOE website for more information.

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