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IBS is a diagnosis of exclusion. But what actually gets excluded varies wildly from one workup to the next, and the conditions most often missed are the ones with real, specific treatments. If you have carried an IBS label for years with no real improvement, this is worth twenty minutes.

In this episode, I'm going to show you what a complete IBS workup actually looks like, the conditions most commonly missed under that label, and the exact questions to bring to your next appointment before you accept IBS as your final answer.

⏱️ TIMESTAMPS
0:00 Before You Accept an IBS Diagnosis, Watch This
0:35 What Rome IV criteria actually require
1:19 Why workups vary so much between doctors
2:07 SIBO, the most commonly missed cause
2:52 Microscopic colitis and why colonoscopies miss it
3:22 Inflammatory bowel disease hiding behind IBS
4:12 Thyroid problems that mimic IBS
5:32 Pelvic floor dysfunction and constipation
5:53 The exact questions to ask your doctor
7:06 How to frame the conversation with your GI doctor

❓ QUESTIONS ANSWERED

What tests are missed most often in an IBS diagnosis?
The two most commonly skipped tests are a hydrogen or lactulose breath test for SIBO and colon biopsies during colonoscopy that could reveal microscopic colitis. Both conditions look identical to IBS on symptoms alone but require specific testing to find.

Can you have a normal colonoscopy and still not have IBS ruled out?
Yes. A colonoscopy without biopsies cannot detect microscopic colitis, which causes chronic watery diarrhea despite a completely normal looking colon. Biopsies are required to make that diagnosis.

Does thyroid function affect IBS symptoms?
Yes. An underactive thyroid slows digestion and causes constipation and bloating, while an overactive thyroid speeds it up and causes loose, urgent stools. A basic TSH panel rules this out quickly but is not always part of a standard gut workup.

📱 RESOURCES
Website: https://www.drmelona.com
Patient Portal: https://drmelona.com/patient-portal/
Unsedated Colonoscopy Video: https://www.youtube.com/watch?v=-Vz1IXF0rmo
Instagram: https://www.instagram.com/polymathforever/
Facebook: https://www.facebook.com/doctormelona

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ABOUT DR. MEL ONA: I'm Dr. Mel Ona, a board-certified gastroenterologist with graduate training in nutritional biochemistry and metabolism. I founded Ohana Gastroenterology and have treated over 10,000 patients across nine years of clinical practice. My focus is evidence-based digestive health, nutrition science, and disease prevention.

#GutHealth #Gastroenterologist #DigestiveHealth #GIDoctor #NutritionScience