The Role of Diagnostic Testing in Irritable Bowel Syndrome
Section snippets
Diagnosis of IBS
The Rome Committee on Functional Gastrointestinal Disorders and other IBS authorities recommend that selected diagnostic tests be performed as part of the routine evaluation of patients with suspected IBS.15, 16 These tests include serum and stool studies, as well as colonic visualization, to exclude important organic gastrointestinal diseases.17 Others propose a limited screen for disorders that may masquerade as IBS, such as celiac disease.18 Recently the necessity of these evaluations has
Yield of diagnostic testing in patients with suspected IBS
The first systematic review of the English language medical literature regarding commonly used diagnostic tests for IBS was performed in conjunction with the ACG IBS Task Force statement in 2002.19 This review included clinical trials that were published between 1980 and 2001, in which patients who fulfilled symptom-based criteria for IBS underwent diagnostic testing. After applying established criteria for the quality and validity of trials,24, 25 6 studies fulfilled inclusion criteria.26, 27,
Summary
The optimal diagnostic approach to IBS continues to evolve. Although there is no completely reliable biomarker that can objectively differentiate IBS from organic disease, the available evidence would support the application of validated symptom-based clinical criteria along with a judicious use of selected laboratory and endoscopic testing. In that sense, the diagnosis of IBS remains a diagnosis of exclusion. In a primary care setting or initial clinical encounter with a patient without
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The opinions and assertions contained herein are the sole views of the authors and should not be construed as official or as representing the views of the US Navy, Department of Defense, or Department of Veteran Affairs.
Disclosure: Dr Cash has served as a consultant to Prometheus Laboratories.