Question

Like many people with ME I also have irritable bowel syndrome (IBS). I have the MEA information leaflet on IBS and have had most of the treatments listed for my various bowel and stomach symptoms. But my symptoms are getting worse, especially the bloating, stomach pain and back pain. My fatigue levels have also increased. I am female, in my early 50s, and have had IBS symptoms for about three years. Do you have any other suggestions?

Answer

Irritable Bowel Syndrome (IBS) should only be diagnosed after making sure that all other causes of symptoms have been excluded. The same applies when IBS symptoms are getting worse despite treatment, or any ‘red flag’ symptoms are present, such as unintentional weight loss, rectal bleeding, or having a family history of bowel or ovarian cancer.

You clearly need to go back to your GP for a proper re-assessment. This should include an abdominal (and possibly pelvic) examination and some tests that include a full blood count (to check for anaemia), ESR or CRP test (which can be raised if inflammation is present), a coeliac disease screening test, a Ca125 test (to measure a protein which can be raised if an ovarian tumour is present) and a stool test for calprotectin (if there is the possibility of an inflammatory bowel disease like Crohn’s). You can also request a referral for an out-patient appointment with a gastroenterologist.

The NHS: Irritable Bowel Syndrome

Overview, Symptoms, Diagnosis, Treatment, Help and Support | February 2021

• • Irritable bowel syndrome (IBS) is a common condition that affects the digestive system.
  • It causes symptoms like stomach cramps, bloating, diarrhoea and constipation. These tend to come and go over time, and can last for days, weeks or months at a time.
  • It's usually a lifelong problem. It can be very frustrating to live with and can have a big impact on your everyday life.
  • There's no cure, but diet changes and medicines can often help control the symptoms.
  • The exact cause is unknown – it's been linked to things like food passing through your gut too quickly or too slowly, oversensitive nerves in your gut, stress and a family history of IBS.

More information

• The ME Association has detailed information available to download from the Free Literature:
  • We examine thyroid disease, review the symptoms and overlap with ME/CFS, the testing that can be done, and the treatments that are available.
  • A significant proportion of people with ME/CFS report that they also have stomach and bowel symptoms very similar to those found in irritable bowel syndrome (IBS). We examine the symptoms, explain how they should to be investigated, and discuss available treatments.
    • You can buy a key from The IBS Network shop or Disability Rights UK shop that can help you access public toilets if you get symptoms while away from home.
  • The Symptoms category of the Free Literature contains all the information you need to know about the most common traits in ME/CFS.
• The NICE Clinical Guideline: Irritable bowel syndrome in adults: diagnosis and management | February 2008 (Updated April 2017).