Since your last exam was four years ago, you need to see your doctor again. Of course, IBS can cause all those symptoms but you cannot be certain until you have been examined and ruled out that nothing more serious is happening. Anytime there is a 'change' in bowel habits, you need to check with your doctor. I wish you the best and keep us posted. I believe there is a thread regarding "tests" that might be appropriate. Some are as follows:Sed rate (general inflammatory immunity marker)CBC (blood counts)Chem-12 (liver and kidney function)H-PyloriUpper GI with biopsy for sprue or other malabsorbtion issues/diseasesLower GI with biopsy (to check for many health conditions)Barrium or CT scan (Motility, lining, tract function and size/thickness, cancer, malformations, diverticuli)Stool sample (three in a row needed to be certain with the "liquid portion")IgG (autoimmune issues)ANA (autoimmune issues)Breath test (for bacterial overgrowth - but it has a high rate of false negative/postives)Good luck and hope you feel better soon!