Is It Really IBS? 9 Conditions That Could Be Causing Your Symptoms

The problem is, IBS is what’s known as a functional disorder, meaning its symptoms have no known or detectable cause – ‘irritable bowel syndrome’  is, therefore, simply an umbrella term covering a wide range of chronic gut issues, coined by doctors in order to give patients a definite diagnosis.

In reality, many sufferers are left in the dark. As it’s not classified as a ‘disease’, doctors often don’t take the condition seriously – book a ten-minute GP appointment to discuss IBS and you’ll most likely be sent on your way with the blanket recommendation to eat more fibre or try probiotics. But with such a wide range of symptoms – all effecting individuals differently, from minor discomfort to severe debilitation – there’s clearly no one-size-fits-all solution.

The condition’s growing prevalence also means patients are being labelled with IBS before being offered more conclusive tests such as colonoscopies, blood work, food sensitivity panels and stool analysis. There’s some evidence of a genetic link too, but the exact genes have yet to be identified.

If you’ve been diagnosed and are still searching for a treatment that works – there is hope. Despite the desperate need for more research, there are a number of known causes of IBS-like symptoms – and, in honour of IBS Awareness Month, we’ve found the nine common conditions well worth looking into…

1. Candida Overgrowth

As registered nutritional therapist Jodie Brandman explains, candida is a type of yeast that naturally lives in our digestive tract. However, when our natural gut bacteria gets out of balance (a common consequence of antibiotics or diets high in simple carbs and sugar), this yeast can overgrow. Other things, like a weakened immune system or a disease like diabetes can also mess with the balance between your body’s bacteria and candida. A stool test can diagnose the condition – and, as sugar feeds yeast, a low-carb diet is often recommended, alongside anti-fungal medication or supplements.

COMMON SYMPTOMS: Bloating, gas, indigestion, urinary tract infections, brain fog, fatigue, fungal nails, athlete’s foot, sugar cravings and recurring thrush.

2. Food Intolerances

Foods high in a particular group of carbohydrates called FODMAP (an acronym standing for fermentable, oligosaccharides, disaccharides, monosaccharides and polyols) can cause IBS-like symptoms for many people – as their bodies are unable to break them down properly. These foods include dairy products such as milk, ice cream and yoghurt; certain fruits like apples, cherries, mango and pears; vegetables such as cauliflower, garlic, onion and mushrooms; grains like wheat, barley and rye; legumes including black beans, kidney beans and tofu; and sweeteners such as honey and agave. Keeping a food diary is the easiest way to discover if intolerances are causing your symptoms.

COMMON SYMPTOMS: Either diarrhoea, constipation or a combination of both. Plus, bloating, gas, stomach cramps and pain – especially after eating certain foods.

3. Coeliac Disease

Coeliac disease is a lifelong autoimmune disease caused by a reaction to gluten – gluten causes the small intestine to become inflamed and unable to absorb nutrients. But despite one in 100 people having the condition, it’s estimated only 24% of coeliacs in the UK are diagnosed – meaning there are many people suffering with the symptoms in silence. As routine testing for coeliac disease isn’t carried out in the UK, it’s often mistaken for IBS. To get a proper diagnosis, you’ll need a blood test from your GP and a gut biopsy from a gastroenterologist.

COMMON SYMPTOMS: Abdominal pain, bloating, constipation and/or diarrhoea, anaemia, skin rashes, mouth ulcers, fatigue, hair loss and unexpected weight loss.

4. Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a term mainly used to describe two conditions: ulcerative colitis and Crohn's disease. Both are long-term, serious conditions that involve inflammation of the gut – ulcerative colitis only affects the colon, whereas Crohn's disease can affect any part of the digestive system, from the mouth to the anus. As certain IBD symptoms are similar to the medical field’s definition of IBS, it’s not uncommon for IBD sufferers to be misdiagnosed. The only way to eliminate IBD is by a colonoscopy, arranged by your GP.

COMMON SYMPTOMS: Pain, cramps or swelling in the tummy, recurring or bloody diarrhoea, weight loss, extreme tiredness, joint pain and anaemia.

5. Endometriosis

Endometriosis is a condition where the lining of the uterus (also known as endometrium) is found outside the uterus, and is estimated to affect two million women in the UK. When sufferers menstruate each month, this tissue swells up and bleeds – but, unlike the tissue in the womb, it has nowhere to escape. It’s this internal bleeding that leads to intense pain, inflammation and the build-up of scar tissue. Due to the fact the condition is often dismissed as ‘women’s troubles’ and not investigated, many doctors end up putting the recurring abdominal pain down to IBS. Endometriosis can only be diagnosed through keyhole surgery, which requires a referral – for the best chance of seeing a specialist, the NHS recommend taking a diary of your menstrual cycle and symptoms to your GP.

COMMON SYMPTOMS: Painful periods, pelvic or abdominal pain throughout your cycle, pain during bowel movements and pain during intercourse. Plus, bloating or diarrhoea – especially during periods, as well as bleeding or spotting between periods.

6. Bowel Cancer

Sometimes called colon or rectal cancer, bowel cancer begins in the large bowel and is the fourth most common type of cancer in the UK. The symptoms can be debilitating but also very subtle in some cases, and won’t necessarily make you feel ill, so the NHS recommends waiting for a short time to see if they get better as the symptoms of bowel cancer are persistent. To rule out bowel cancer, your GP will carry out a simple examination of your stomach and back passage to check for lumps, arrange for a blood test to check for iron deficiency anaemia (which can indicate whether there's any bleeding from your bowel that you’re unaware of), and arrange for a colonoscopy to be carried out.

COMMON SYMPTOMS: Persistent changes in your bowel habits, persistent blood in your stools and persistent lower abdominal pain, bloating or discomfort – this will always be caused by eating and is linked with loss of appetite and significant unintentional weight loss.

7. SIBO

We all need bacteria in our colon for healthy digestion, but those suffering from SIBO – which stands for small intestinal bacterial overgrowth – have significantly more than normal. There are certain conditions associated with SIBO, including diabetes, scleroderma, Crohn’s disease and obstruction of the small intestine, but it can also be caused by multiple courses of antibiotics, food intolerances, low stomach acid and gastroenteritis. Research shows SIBO could be the underlying cause for a huge number of IBS cases – one study in the American Journal of Gastroenterology found SIBO to be present in 84% of IBS patients tested. It’s diagnosed via a hydrogen breath test and most successfully treated with a combination of probiotics, herbal supplements and the Specific Carbohydrate Diet (SPD).

COMMON SYMPTOMS: Excess wind and belching, abdominal bloating and distension, constipation and/or diarrhoea, abdominal pain, vitamin and mineral deficiencies, body aches and fatigue.

8. Intestinal Parasites

While many people believe parasites are only found in developing countries or exotic locations, it’s definitely possible to contract them in the UK. The most common intestinal parasites include tapeworms, roundworms, hookworms and pinworms. According to the NHS, people should be wary of eating raw or undercooked beef, pork or freshwater fish; drinking water or eating food that has come into contact with an infected person or animal; and close contact with someone who has parasites. It’s also vital to wash your hands before eating or touching your mouth. Intestinal parasites can usually be treated with a single dose of prescription medication – your doctor will most likely ask you for a stool sample in order to give a correct diagnosis.

COMMON SYMPTOMS: Unexplained digestive issues such as diarrhoea, constipation or stomach cramps, rarely feeling full after meals, skin irritation, frequent tiredness, anaemia and finding worms or segments of worms in your stools.

9. Ovarian Cancer

Ovarian cancer, or cancer of the ovaries, is one of the most common types of cancer in women. And although it mainly affects women over the age of 50 who’ve been through the menopause, younger women can be sufferers too. Unlike IBS, symptoms of ovarian cancer are frequent and persistent and don’t come and go – but as some of the symptoms are similar, misdiagnosis is common. It’s therefore essential to tell your GP you’re specifically worried about ovarian cancer if you’re experiencing them, especially if you have significant family history of ovarian or breast cancer on either side of your family.

COMMON SYMPTOMS: Feeling constantly bloated, having a swollen tummy, discomfort in your abdominal or pelvic area, feeling full quickly when eating, needing to urinate more urgently and frequently.