Irritable bowel syndrome other diagnostic studies
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In young patients with symptoms of classic irritable bowel syndrome (IBS), additional invasive investigations such as endoscopy are not required and increase patient dissatisfaction. However, endoscopic evaluation is performed in difficult cases of IBS where history is unclear but the physical examination is suggestive of the diagnosis. All IBS patients with alarm features must undergo endoscopic evaluation. Moreover, colonoscopy must be considered in patients aged more than 50 years as part of routine colon cancer screening. Sigmoid colon biopsies and duodenal biopsies are required for exclusion of microscopic colitis, Crohn's disease, and celiac disease. Anorectal manometry is a diagnostic technique used to rule out obstructive defecation (pelvic-floor dyssynergia).
Other Diagnostic Studies
In young patients with symptoms of classic irrfitable bowel syndrome (IBS), additional invasive investigations such as endoscopy are not required and increase patient dissatisfaction. However, endoscopic evaluation is performed for the following indications:
- Gastrointestinal endoscopy is done in difficult cases of IBS where history is unclear but the 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 biopsies.
- IBS patients with dyspepsia should undergo esophagogastroduodenoscopy.
- Sigmoidoscopy is performed in patients in order to exclude melanosis coli due to laxative abuse and microinflammation.
- Sigmoid colon biopsies and duodenal biopsies are required for exclusion of microscopic colitis, Crohn's disease, and Celiac disease.
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