A patient guide to digestive conditions like IBS and inflammatory bowel disease — what to expect from gastroenterology referrals and how to get answers.
Digestive symptoms can be frustrating and sometimes embarrassing to talk about, but gastroenterologists hear about these things every day — nothing will surprise them. Your GP will usually run some initial blood tests (including a coeliac screen and inflammatory markers like CRP and faecal calprotectin) before referring you. If you have blood in your stool or unexplained weight loss, your referral should be flagged as urgent.
Before your appointment, keep a food and symptom diary for at least a week. Note what you eat, when your symptoms happen, and what your bowel habits look like (frequency, consistency, urgency). The Bristol Stool Chart is a helpful reference — your gastroenterologist will almost certainly ask about it. Also note any foods you have cut out and whether it made a difference.
Bring the results of any tests your GP has already done. If you have private insurance, gastroenterology is usually covered, but check whether endoscopy procedures have separate authorisation requirements.
Your gastroenterologist will ask detailed questions about your symptoms, diet, stress levels, family history (especially of bowel disease or bowel cancer), and any medications you take. They will likely examine your abdomen.
Depending on your symptoms, they may recommend further tests. A colonoscopy (a camera examination of your large bowel) is the gold standard for diagnosing inflammatory bowel disease and ruling out other conditions. It requires bowel preparation the day before — your hospital will give you clear instructions. An upper endoscopy (gastroscopy) looks at your oesophagus, stomach, and duodenum. Both are done under sedation if you prefer.
If IBS is suspected (and inflammatory markers are normal), your gastroenterologist may diagnose this based on your symptoms without needing a colonoscopy. IBS is a real condition, not a dismissal — and there are effective treatments.
If you are diagnosed with IBS, your gastroenterologist or a specialist dietitian may suggest the low FODMAP diet, which has strong evidence behind it. This is best done with professional guidance rather than trying it alone. Other treatments include antispasmodics, low-dose antidepressants (used for their gut-calming effects, not for depression), and psychological therapies like gut-directed hypnotherapy, which the NHS is increasingly offering.
If you are diagnosed with inflammatory bowel disease (Crohn's or ulcerative colitis), you will usually be started on medication to control inflammation and monitored regularly. IBD specialist nurses are an invaluable resource — make sure you have their contact details. Crohn's & Colitis UK offers excellent support, a helpline, and a "Can't Wait" card for urgent toilet access.
Whatever your diagnosis, do not suffer in silence. Digestive conditions are very common and very treatable — but they often need adjustments over time, so stay in touch with your team.
Print this list or save it on your phone. It is easy to forget what you wanted to ask once you are in the room.
NuCover can help you find the right consultant — through the NHS, private insurance, or self-pay. Tell us what you are experiencing and we will point you in the right direction.
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