If you’ve been diagnosed with IBS due to daily explosive, watery smelly diarrhea that comes with little warning, you might not have IBS after all.

You may actually have a condition that requires a treatment that’s different than the one for irritable bowel syndrome.

This is why your “IBS treatments” have not been working, and the explosive, watery diarrhea that stinks up the bathroom and beyond keeps on happening.

You may have an uncommon and often overlooked condition called microscopic colitis.

I was diagnosed with this years ago. Funny thing, though, while I was being prepped for the colonoscopy to find out why I was having sudden-onset diarrhea, the nurse already was telling me it was probably IBS.

Microscopic colitis is named so because it requires analysis of a tissue sample from the colon under a microscope for identification.

If you’ve been diagnosed with IBS but have not had a very recent colonoscopy — and, no treatments are working — you’ll want to ask your gastroenterologist if a (new) colonoscopy might reveal a condition that explains your frequent episodes of explosive, watery diarrhea that are disrupting your daily activities.

What sometimes comes with microscopic colitis is noisy gurgling in the belly until the diarrhea is voided.

There may also be cramping as the latest episode of the messy diarrhea is brewing up, and the cramping disappears once all is voided.

Do you always make sure you know where the nearest restroom is when out in public?

Have you had “accidents” while en route to the nearest restroom?

Extreme urgency is also a hallmark sign of microscopic colitis, though it doesn’t occur with every episode of the diarrhea.

Ask your gastroenterologist if you’ve had every test possible to rule out a cause for your symptoms other than irritable bowel syndrome.

Ask about a colonoscopy, even if you’re young, even if you had one only a few years ago.

Microscopic colitis is often misdiagnosed as IBS, and not all patients who have an IBS diagnosis had a recent colonoscopy!

The management of microscopic colitis is completely different than it is for IBS, which is why the treatment for IBS will not be effective for microscopic colitis.

Do not be afraid of having a colonoscopy. Microscopic colitis is a benign, though sometimes disruptive, condition.

Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 



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