Review

Diagnosing Irritable Bowel Syndrome: A Changing Clinical Paradigm

Authors: Phillip K. Henderson, DO, Jack A. DiPalma, MD

Abstract

Rather than being a diagnosis of exclusion, irritable bowel syndrome (IBS) is a diagnosis that can be identified by symptom-based criteria. The collection of these criteria by a meticulous history can be enhanced by using various tools. Once a positive diagnosis is made, using clinical criteria for diagnosis, one should look for alarm or warning symptoms or signs, and should characterize the type of bowel habit. Determining whether the condition is a diarrhea-predominant or a constipation-predominant IBS will direct further diagnostic evaluation and management.


Key Points


* IBS is diagnosed by symptom-based clinical criteria.


* A positive diagnosis using clinical criteria can avoid exhaustive diagnostic testing.


* Characterizing the bowel habit as diarrhea- or constipation-predominant will direct further diagnostic evaluation and management.

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