Have you just been diagnosed with IBS? This post will tell you everything you need to know, plus what to do about it.

How Did My Doctor Decide It’s IBS?


First up, you need to know what IBS (Irritable Bowel Syndrome) is: it’s a diagnosis that is made when all other possibilities have been ruled out.

There is no specific test that your doctor can order to diagnose IBS.

This means that you will be taking lots of different tests, depending on how your digestive symptoms are presenting. Some of these might include:

  • Colonoscpoy and/or Endoscopy
  • Celiac Serology/Gene testing
  • Helicobacter Pylori Breath Test
  • Glucose breath test
  • Stool test for parasites

There are far more tests than this, such as food intolerance testing and microbiome mapping, but your doctor will be unlikely to order these because they are not typically trained to understand them.

If all of your tests come back as “normal”, then you will officially be diagnosed with IBS. The final diagnosis will be based on symptoms, which leads us to…


The Rome III Criteria


The Rome III Criteria are the criteria used by health professionals to diagnose IBS. Everything below covers what you need to know.


The 4 main categories for IBS:


IBS-D: this refers to Diarrhoea-dominant IBS. This is the category you belong to if you have symptoms that mostly result in a diarrhoea flare (3+ loose, watery stools per day).

IBD-C: this refers to Constipation-dominant IBS. This is the category you belong to if you have symptoms that mostly result in constipation. e.g. 2+ days without a bowel movement, or difficulty passing a stool, even if you’re having one every day.

IBS-M (a.k.a IBS-A): this refers to Mixed IBS (a.k.a Alternating IBS). This is when there is a swing between constipation and diarrhoea for you when you have a symptom flare.

IBS (Unsubtyped): this refers to those lucky people with lots of abdominal pain, constipation, diarrhoea and everything in between – there is no clear dominance of any of the above. The common factor is the regular digestive pain.


What Causes IBS?


Just like your symptoms, the causes of them can be totally unique. Your drivers can be completely different than another person, even though you may both have the same subtype diagnosed!


The Most Common Causes of IBS:


  • Antibiotic use (it can take 18 months to recover from one course of antibiotics)
  • Having a previous infection that was bacterial or viral (called “post-infectious IBS”)
  • Endometriosis
  • Food intolerance
  • FODMAP Sensitivity
  • Nutrient deficiency
  • A side-effect of medication you may be taking to treat another condition
  • Stressful events, Chronic Stress, Anxiety and Depression
  • Consumption of processed foods
  • Alcohol consumption
  • High-level sugar consumption
  • Having another digestive disease, such as Crohn’s, Ulcerative Colitis, Diverticulitis or Pancreatitis
  • An undiagnosed infection, such as SIBO (Small Intestinal Bacterial Overgrowth)
  • Dysbiosis


Please keep in mind that this is by no means an exhaustive list; there are endless connections in the mind map of your symptoms and triggers.


The Rome IV Update


Rome IV is the updated addition to the Rome Criteria family that expands on the Rome III stuff we discussed further up. Basically, this leaves the above concept intact, with a key change in how you’ll be categorised:

Before this update, IBS was considered to always be related to “symptoms improving with defecation”.

Now, you’re categorised under the IBS umbrella if your symptoms are “related to defecation”. This is because of the number of people who actually feel worse after they have a bowel movement (something I hear from IBS clients all the time).


A Whole New Category


There also has been a whole other category specifically introduced for those using painkillers such as Oxycontin, Codeine or Fentanyl. This is called “Opioid-Induced Bowel Dysfunction“. It relates to the IBS symptoms experienced by those using painkillers to manage their pain. The use of these medications leads to dysbiosis, which explains why it’s got its own IBS category.


What’s Still Missing


I wish I could see a major overhaul in the idea of IBS being a “functional digestive disorder.” It’s is never just a problem with your digestion – it’s tightly connected with your whole body and your mind.

Our brain health, our immune health and more are all affected by our gut health and vice versa. I’ve never heard of a case of IBS that didn’t affect some other aspect of health, whether it’s joint/bone density, mental/brain health, reproductive issues, skin problems, hormone issues or autoimmune disease.


The Tolle Totum Difference


At Tolle Totum, we understand what it’s like to have IBS. We understand what it’s like to have your life deeply restricted by constant pain, nausea, bloating and stress about where the nearest bathroom is. We know what it’s like to fear food.

If there’s one basic piece of information you can take home from this post, please let it be this: your IBS is not isolated to your digestive system. It’s a symptom of something that has a root cause, and we won’t stop until we find yours.


What We Can Do To Help


If you want to know more about what we can do to help you with your IBS symptoms, book in for a FREE 15-Minute Gut Health Assessment right now! We’ll talk about where your digestive health is at right now, and how you need to progress to get on with your busy life.

I can’t wait to help with putting you in charge of your body!

Lauren Booth

BHSc (Nat)

Nutritionist & Naturopath



Share the "Like"!

Share the "Like"!