Because IBS is a constellation of symptoms, it is very important to make sure that a thorough history and physical examination is performed to make sure that patients don’t have any alarm symptoms or any other signs of other conditions such as inflammatory bowel disease, celiac disease, microscopic colitis, thyroid diseases. All of those conditions can mimic symptoms of irritable bowel syndrome, so it’s important for your physician to ask all the necessary questions to exclude these other conditions. Sometimes it’s not so clear. They may require blood work. They may require stool tests to rule out infections. They may even require an endoscopy or a colonoscopy if the symptoms are not clear-cut and you have risk factors for some of these other conditions.