Digestive Disorders > IBS

Which irritable bowel test is the best?

Dr. med. Andre Sommer

Dr. med. Andre Sommer

Many people with bowel problems wonder if they have irritable bowel syndrome (IBS). This can only be confirmed by extensive tests as part of an irritable bowel diagnosis carried out by a doctor. A diagnosis based on pure self-tests is very dangerous because a doctor must rule out diseases such as colorectal cancer. This is by no means possible with irritable bowel tests online or with naturopaths. Once the diagnosis is confirmed,** **irritable bowel tests help determine the course and severity of the disease. During therapy, irritable bowel tests provide information about the success of the treatment.

What irritable bowel tests are there?

The following two IBS tests are important to know:

  1. Disease severity: IBS-SSS (IBS Severity Scoring System), a questionnaire to record the severity of IBS
  2. Reduction of quality of life: IBS-QOL (Irritable Bowel Syndrome Quality of Life), a test to assess the quality of life with IBS

What is the IBS-SSS test?

The IBS-SSS is a very frequently used test that measures the severity of the disease in those with irritable bowel syndrome. It was validated in English in 1997 and in German in 2013 in a larger group of patients and has since been used in many medical studies and in everyday clinical practice. In the test, the doctor and patient assess, among other things, pain, flatulence, bowel problems, and quality of life.

  1. In the **first part **of the test, the severity of symptoms is assessed using questions.
  2. The **second part **of the test asks for more information about the symptoms, such as the texture and consistency of the stool and the location of the abdominal pain. The test result is a score that indicates the severity of the digestive problems. The IBS-SSS takes a total of about five minutes.

How is IBS severity tested?

Here are a few modified example questions:

Test questions for abdominal pain

  • Do you currently have abdominal pain? (Yes/No)
  • How severe is your abdominal pain on a scale from zero to ten (0 = no pain, 10 = extremely severe pain)
  • How many days in the past week have you had abdominal pain?

Test questions for bloated stomach and flatulence

  • Do you currently have a bloated stomach or flatulence? (Yes/No)
  • How pronounced is the bloated stomach on a scale from zero to ten?

Test questions for stool behavior

  • How satisfied are you with your bowel movements on a scale from zero to ten? (0 = very satisfied, 10 = very unsatisfied)
  • How often do you have bowel movements per week?

What is the IBS-QOL test?

The IBS-QOL is a test for the quality of life of those who suffer from IBS. It takes about ten minutes and has been translated into different languages. The test consists of 34 questions and provides a score that shows the quality of life of those with IBS: A high test result indicates a good quality of life.

How exactly is quality of life measured in those with IBS?

Different tests and questionnaires are used to measure the course and severity of IBS. These give the doctor and patient feedback on how severe the disease is. The quality of life plays a special role in chronic diseases, since the disease can have a negative impact on many areas of life. If several of the following questions apply to you, it may well be that your quality of life is suffering due to digestive problems. The questions are a modified excerpt from the IBS-QOL:

  1. I feel helpless and vulnerable due to my bowel problems.
  2. It bothers me how often I have to go to the bathroom.
  3. I feel fat because of bowel problems.
  4. I feel isolated and lonely because of my bowel problems.
  5. I can’t really enjoy life because of my bowel problems.
  6. I'm losing control of my life because of my bowel problems.
  7. I find it difficult to talk about my bowel problems.
  8. I have to be careful what and how much I eat because of my digestive problems.
  9. My sex life suffers because of my bowel problems.
  10. I am afraid to burden my fellow human beings with my bowel problems.
  11. I am afraid that my bowel problems will worsen.
  12. My bowel problems limit what I can wear.
  13. I have the feeling that nobody understands my bowel problems.
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How do people with IBS experience their illness?

Suffering from IBS is very frustrating because the disease dominates everyday life due to its unpredictability. Affected people often have certain negative thoughts in mind that resemble the following questions:

  1. Can I wear this despite my bloated stomach?
  2. How will my stomach react when I eat this and that?
  3. What do the others think if I keep running to the toilet?
  4. What do I do if there is no toilet nearby?
  5. How do I explain my problem to others?
  6. What happens if I cancel the appointment because of my problems?
  7. What do I do if I get hungry and can't find anything to eat?

In some cases, those affected also feel dirty and disgusted with themselves. In other cases, social and sexual life are significantly restricted.

What concerns do those with severe intestinal problems have?

With particularly severe and long-lasting bowel problems, it is usually not the physical symptoms such as diarrhea, constipation, abdominal pain, or flatulence that are the most stressful. Rather, the social and psychological restrictions caused by IBS are perceived as particularly stressful. Certain tests have shown that three feelings are particularly dominant here:

  1. Frustration
  2. Isolation
  3. Dissatisfaction with health care

How severely does IBS restrict quality of life?

It is often underestimated how much the quality of life suffers in people with IBS. On average, people with mild to moderate symptoms state that they are limited by IBS in everyday life for 73 days a year. This corresponds to a reduced quality of life every fifth day.

Do doctors and patients agree on the severity of IBS?

No, mostly the assessments differ. Doctors and patients often have different theories about the cause and severity of IBS, but also about the method and success of treatment. Doctors rate the severity of irritable bowel symptoms and the reduction in quality of life on average less seriously than the affected patients. To date, no precise causes of IBS are known, so patients are often dissatisfied with the answers given by their doctors.

Treatment options are also limited. Many patients suspect that their diet (e.g. allergies and intolerances) or psychological problems are responsible for the disease, although their doctors cannot confirm this. All of these factors make the doctor-patient relationship complex and can make it difficult to treat IBS.

Betz, C., Mannsdörfer, K. and Bischoff, S.C., 2013. [Validation of the IBS-SSS]. Zeitschrift fur Gastroenterologie, 51(10), pp.1171-1176. Downloaded on 09/05/2016 from https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0033-1335260

Houghton, L.A., Heitkemper, M., Crowell, M.D., Emmanuel, A., Halpert, A., McRoberts, J.A. and Toner, B., 2016. Age, Gender, and Women’s Health and the Patient. Gastroenterology, 150(6), pp.1332-1343. Downloaded on 09/05/2016 from http://www.gastrojournal.org/article/S0016-5085(16)00183-9/abstract

Drossman, D.A., Patrick, D.L., Whitehead, W.E., Toner, B.B., Diamant, N.E., Hu, Y., Jia, H. and Bangdiwala, S.I., 2000. Further validation of the IBS-QOL: a disease-specific quality-of-life questionnaire. The American journal of gastroenterology, 95(4), pp.999-1007. Downloaded on 09/05/2016 from http://www.nature.com/ajg/journal/v95/n4/fig_tab/ajg2000256t4.html

Francis, C.Y., Morris, J. and Whorwell, P.J., 1997. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Alimentary pharmacology & therapeutics, 11(2), pp.395-402. Downloaded on 09/05/2016 from http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2036.1997.142318000.x/epdf

Dr. med. Andre Sommer

Dr. med. Andre Sommer

I’m André, a medical doctor from Berlin. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara.

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