When you have irritable bowel syndrome (IBS), experiencing any symptoms, even mild ones, can impact your quality of life. If you’re living with IBS, you’ll know that there are times when your symptoms get worse. Sometimes, other severe symptoms may occur that you think are related to your IBS but are really caused by another condition.

One way to establish a good relationship with your doctor is to ask them about the circumstances and symptoms they would like you to call them about. Because your doctor knows your unique health history, they can establish guidelines in advance to help you answer the questions “Is this normal?” and “Is this worth calling my doctor about?” Read on for specific instances and occasions that warrant picking the phone and calling your doctor’s office.

While doctors don’t exactly know what causes IBS, multiple factors can contribute. These include that your gastrointestinal (GI) tract is more sensitive to the effects of bacteria, gas, and bloating. Hormonal swings, stress, and anxiety can also aggravate the digestive tract, as can eating certain foods known to contribute to GI upset. All of these factors can come together to cause IBS symptoms.

You may go through time periods where you have no IBS symptoms at all. Then, you may experience symptoms that are severe in nature. If you experience any of the following symptoms, call your gastroenterologist or the primary care provider that treats your IBS:

• Abdominal pain: While you may experience occasional abdominal pain, having severe pain is a warning sign that you should call your doctor. Severe pain is pain that you would rate a 7 or higher on a scale of 1 to 10, with 10 being the worst pain ever.
• Cramping: Severe cramping that makes it hard to accomplish daily tasks should not be ignored and is often a sign that your bowels are moving too fast.
• Gas: Gas that is strong-smelling, foul-smelling, or otherwise different from your usual patterns is a cause for concern. Sometimes gas can also be painful and may make it difficult for you to go to work or school.
• Mucus in your stool: Sometimes when your gastrointestinal tract is irritated, your colon may start releasing mucus.
• Severe diarrhea and/or constipation: While diarrhea and constipation may be symptoms of your condition, any symptoms that are out of the ordinary for you, such as an extended time period of either symptom, can indicate cause for concern.

As a general rule, any time you experience symptoms that are worse than your usual symptoms or new symptoms that affect your daily life, talk to your physician.

If you’ve recently started new medications related to your IBS, you may also wish to call your doctor and ask if any new symptoms are related to your medications. For example, some medications to stop intestinal spasms and cramping can cause constipation or problems urinating. However, you should not stop taking your medications unless your doctor advises you to do so.

Sometimes you may have abdominal symptoms that you think are related to your IBS but are actually symptoms of another condition. If one of these symptoms is blood in your stool, you should seek immediate medical attention. Blood in your stool or black, tarry stools could indicate the presence of a GI bleed, where an area of your intestine or stomach is bleeding. Blood in the stool is not a typical symptom associated with IBS. While mucus in the stool may be expected, blood in the stool is not.

Other symptoms that you may experience that do not typically occur with IBS include:

• feeling dizzy
• joint, skin, or eye discomfort
• pain that is getting progressively worse
• significant lack of appetite
• sudden weight loss
• symptoms that occur only at night that cause you to wake up frequently

If you have a family history of serious gastrointestinal disorders, and you experience the above-mentioned symptoms, contact your doctor. Examples of these disorders include inflammatory bowel disease, celiac disease, or cancer.

If you experience changes in your symptoms, your doctor will likely conduct tests to find out what may have caused these changes. First, your doctor will ask you questions about your symptoms. They may ask questions like:

• When did you first notice your symptoms?
• How long have the symptoms been going on?
• Do you notice anything that makes your symptoms worse or better?
• Are you taking any new medications or have you changed your diet recently?

Your doctor will use your answers to these questions as a jumping-off point to determine a likely cause. Depending upon your symptoms, your doctor may order a blood test to ensure your blood levels are at an expected range. If your doctor thinks that inflammation or bleeding somewhere in your intestinal tract may be the cause, they may recommend a colonoscopy to view the inner lining of your colon for any irregularities.

Ideally, you should seek medical treatment as early as possible when you experience a change in your IBS symptoms. This can help your doctor determine if the change is cause for more treatments or a sign of another condition. Remember, anything that worries you is worth calling your doctor about.