How to Talk to your Doctor about IBS

If you’ve been suffering from gastrointestinal symptoms that interfere with your work or social life, you would be well advised to bring them to the attention of your primary care provider. You might decide to make a special appointment for this, especially if your symptoms are new, or to bring it up at your next scheduled check-up.  How can you make the most of your doctor’s appointment?

• Start with your primary care provider.
• For your own safety, do not self-diagnose. You want your provider to evaluate your symptoms using all of his or her diagnostic skills, not just note in your chart “history of IBS”.
• When you make your appointment, don’t be shy about the reason for your visit, what we call your “primary complaint”.  Your provider will put your primary complaint at the top of the list for discussion during your visit. If you aren’t sure how to communicate this to the scheduler without a lot of potty talk you could try “change in bowel habits” or “abdominal pain”; even “GI issues” is better than nothing.
• Make a list of your symptoms and bring it to your appointment. When did they start? What seems to bring them on? Review the alarm symptoms in Is it IBS so you can tell the doctor everything that he or she will need to know to plan your work-up or to make a diagnosis.
• It is perfectly OK for you to bring up the subject of a referral to a specialist. Try some of the following phrases: “Do my symptoms warrant referral to a gastroenterologist for evaluation? Why or why not?”; “I’ve been thinking I’d like to see a nutritionist for help with my IBS. Can you suggest a registered dietitian who works with GI patients?”; Depending on your insurance and local operating procedures, you may be able to self-refer to a gastroenterologist or registered dietitian, but your specialist will have more to work with if your primary care provider formally refers you and sends along your medical records.
• Be respectful of the doctor’s expertise and talk as though your two are on the same team when requesting lab tests. “I’d like to be more certain it isn’t celiac disease before I start changing my diet—how could we rule that out? I’m concerned about it because of my anemia and because it runs in the family.” This approach works better than either demanding tests or expressing worry that you might have this-or-that disease, which the doctor may dismiss as anxiety. The “rule out” idea is important in the diagnosis of IBS and your doctor will find it easy to relate to.

Even if you have suffered with gas, bloating, abdominal pain, diarrhea or constipation for years, now is the time to put these symptoms back on the examination table; many new treatment approaches have been developed in the past few years, including elimination diets, probiotics, and new medications. No one should settle for learning to live with IBS without a proper evaluation and a chance to try these new therapies.

Comments

[Lisa Braithwaite]

It's heartbreaking how many people are handed a sheet of paper and told by their doctor to "avoid these foods," with no explanation of an elimination diet or reintroduction of foods. I've heard from several people on a FODMAP group here on FB that they thought the elimination diet was meant to be their permanent solution to IBS. Kind of scary when you think about the potential for malnutrition. I recommend your (very thorough and easy to follow) book to everyone as often as I can.

[Patsy Catsos]

Thanks for that! I do emphasize a FODMAP elimination/challenge protocol should be a temporary learning diet, and the goal is the most liberal and varied diet each person can tolerate. True, there will be some people that can liberalize the diet much more than others, but I believe everyone should try. The philosophy is experimentation and individualization. This is a major difference between the FODMAP approach and many of the other, more zealous gastrointestinal health diets diets out there.