Doctor Discussion Guide: What to Bring Up Even If Your IBS Is Under Control

Medically reviewed by Elaine K. Luo, MD on March 13, 2017Written by Kimberly Holland on March 13, 2017
ibs

You may be happy with how your current irritable bowel syndrome (IBS) treatment is working, but that doesn’t mean you shouldn’t keep a careful eye on your symptoms and condition. Here are nine questions to bring up to your doctor at your next checkup to make sure you continue to stay on track.

1. Is there more I can do?

This is a broad question, but it’s a great discussion starter. Use this question to open up your doctor to ideas beyond what you’re doing currently. Lead the discussion, but be open to your doctor’s thoughts and suggestions. Write down any recommendations they have, and follow up closely so you feel empowered with the information they’re giving you. If the conversation stalls or you want to head in a different direction, use the other nine questions to dig for more information.

2. If the treatment stops working, how will I know? What can I do?

This may be your most pressing question. Yes, the treatment plan you have now works, but what happens if it doesn’t? Living with untreated symptoms of IBS is possible, but it isn’t fun — and it certainly impacts your quality of life.

Ask your doctor what signs to look for when a treatment has stopped working. Is one flare-up a problem? Should you have continual symptoms for several weeks? At what point is another appointment with your doctor necessary? Should you call your doctor’s nurse and report problems before coming in for a visit?

Together, you two should create a plan of action so you feel secure in knowing what your steps are if treatments stop working and symptoms return.

3. Could this be a symptom of another condition?

IBS is often a diagnosis of exclusion: Once everything else is ruled out, your doctor may decide your symptoms are the result of IBS. Your doctor will likely test for a wide variety of conditions, so if something else is going on, one of these tests should identify it.

Still, ask if you two need to revisit your diagnosis at a later point. Maybe the treatment is helping ease symptoms now, but if things change, it may be worth considering a diagnosis change.

4. What are my triggers? Can triggers change over time?

IBS triggers are foods or lifestyle factors that can set off IBS symptoms. Triggers are different for each type of IBS, and from one person to another. Your triggers can change over time too.

Common triggers include:

  • stress
  • anxiety or depression
  • pain
  • high-fat or fried foods
  • processed foods, including snack cakes, cookies, or chips
  • caffeine
  • chocolate
  • carbonated beverages
  • alcohol
  • artificial sweeteners

If you don’t already know your triggers, the best way to discover them is to keep a journal. Write down events that happen, what you eat, how you feel, and when symptoms began. Likewise, include any treatments you use, changes you make to your diet, or other components that may influence your body’s response.

Your doctor can review this journal to find possible triggers, identify changes, and help shape adjustments you can make for your treatments.

5. Do I need regular tests?

Before you’re diagnosed with IBS, your doctor may order several tests. These help your doctor rule out other possible conditions so that they can make a clear diagnosis.

Your doctor may want to regularly monitor your GI tract for changes. Ask how often, if at all, you need more tests. This information can help you plan for your future, and it can help you take into account any financial considerations you might need to make.

6. Should I keep tracking my food?

A journal is a great way to identify possible food triggers. It’s also a way to see how your body responds to different types of foods. This is helpful as you begin balancing your diet, removing possible trigger foods, and incorporating more healthful foods.

However, depending on where you are with your diagnosis and state of treatment, a journal may not be necessary. Instead, your doctor may tell you to only keep a journal when the condition is more active and you’re having symptoms frequently. Discussing the need for a food journal can help the two of you get on the same page about monitoring food intake and your body’s reaction over the long term.

7. Should I be eating more fiber?

If you have IBS with constipation (IBS-C), your doctor may suggest maintaining a healthy level of fiber in your diet. Fiber can help reduce symptoms of IBS-C, including bloating, pain, and hard stools.

Don’t add a lot of fiber all at once. Too much fiber too quickly may actually make symptoms worse. Instead, begin slowly, and add small bits during your day. For example, eat a low-sugar, high-fiber breakfast like oatmeal or cereal. Add fruit to your lunch, and look to side dishes of broccoli, peas, or beans for dinner. Make sure you eat a variety of fiber-rich foods, and try to eat them throughout the day so you maintain a regular supply of fiber for your GI tract.

If you have IBS with diarrhea (IBS-D), you need to be pickier about the type of fiber you eat. Seek out sources of soluble fiber over sources of insoluble fiber. Soluble fiber takes longer to go through your GI tract, so it helps maintain healthy colon function. Sources of soluble fiber include apples, beans, carrots, citrus fruits, oats, and peas. Insoluble fiber is found in wheat, corn, root vegetables, and more.

8. What are the risks of using some alternative treatments?

Results of using alternative treatments are mixed. This question opens up a lot of room to talk about the many types of alternative treatments recommended for people with IBS: You may be considering acupuncture or meditation, but your doctor may think you’re referring to herbs and teas. Some of these treatments have valid research to support them, and some don’t.

Talk with your doctor about the specific alternative treatments that interest you, ask for advice on incorporating them into your treatment plan, and ask if you should try any others. If your doctor isn’t open to the concept of using traditional treatments with complementary therapies but you’d like to consider them, you may need to seek a second opinion.

9. Should I join a support group?

It’s important to know you aren’t alone. IBS is quite common. One study estimates that 11 percent of the global population deals with some form of IBS. In fact, you probably know at least one other person who’s been diagnosed with the condition.

Support groups are an empowering way to connect with others who face the same questions and concerns as you. They allow you to openly discuss your ideas, talk about experiences, and feel supported through the ups and downs.

Many hospitals organize support groups for various conditions. Ask your doctor’s office for a recommendation, or seek out your local community health office. You may not feel you need a support group right now, but the day may come when you do.

CMS Id: 117213