Irritable bowel syndrome other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There are no other diagnostic studies associated with [disease name].

OR

[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

• There are no other diagnostic studies associated with [disease name].

• [Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include:
  • [Finding 1]
  • [Finding 2]
  • [Finding 3]
• Other diagnostic studies for [disease name] include:
  • [Diagnostic study 1], which demonstrates:
    • [Finding 1]
    • [Finding 2]
    • [Finding 3]
  • [Diagnostic study 2], which demonstrates:
    • [Finding 1]
    • [Finding 2]
    • [Finding 3]

• Gastrointestinal endoscopy is done in difficult cases of IBS where history is unclear but physical examination is suggestive of the diagnosis.
• All IBS patients with alarm features must undergo endoscopic evaluation.
• Colonoscopy must be considered in patients aged more than 50 years as part of routine colon cancer screening.
• In IBS patients with persistent diarrhea of age >40 years, a colonoscopy should also be performed to rule out organic causes like IBD and perform sigmoid colon biopsies for microscopic colitis.
• IBS patients with dyspepsia, should undergo esophagogastroduodenoscopy.
• Sigmoidoscopy is performed in patients in order to exclude melanosis coli due to laxative abuse and inflammation.

The difficult clinical decision is when to proceed to

colonoscopy or barium enema. This decision should be

made by a specialist, and depends mainly on the

individual patient’s risk. Risk is influenced by age (young

patients are very unlikely to have malignant pathology),

family history, duration of symptoms (IBS symptoms are

long-lived), and the presence of any sinister symptoms

(eg, rectal bleeding, weight loss, anorexia).

Melanosis coli indicating

laxative use and microinflammatory disease can be identified

during colonoscopy. Endoscopy is unnecessary in

young patients with classic irritable bowel syndrome

symptoms.69

Endoscopy is an expensive and limited resource, thus

we should probably reserve use of it for patients with

persistent diarrhoeal symptoms in whom duodenal and

colonoscopic biopsy specimens might be needed to

exclude coeliac disease and microscopic colitis,

respectively. However, the diagnostic yield of colonic

biopsy is very low.109,113 A high proportion of patients do

improve during follow-up, so a staged approach, though

lengthy, could save resources and avoid unnecessary

procedures.   

coeliac disease.110

crohns, diagnosis of this disorder generally

cannot be made without radiological analysis of the

small bowel,

flexible sigmoidoscopy with biopsies.

Diagnosis

obstructive defecation (pelvic-floor dyssynergia) should be considered,

anorectal manometry can confirm the diagnosis.

.