IBS and the Diagnostic Process

If you didn’t already know, I am a huge fan of the International Foundation for Functional Gastrointestinal Disorders (IFFGD). One of the things I love the most about membership is receiving their quarterly newsletter, Digestive Health Matters. The current issue, Winter 2008, has an extremely interesting article regarding the problems inherent in diagnosing IBS. The article, “Diagnostic Testing in Irritable Bowel Syndrome: Theory vs. Reality”, discusses the tendency of physicians to order diagnostic procedures rather than simply relying on the Rome III criteria. The author makes the claim that if a patient meets the Rome III criteria that there is a 98% chance that they have IBS and not some other disease.

As this 98% number seemed so high, I dug a little deeper. The author of the IFFGD article based this on a study published in 2002 in the American Journal of Gastroenterology. Sure enough, that study found that the risk of finding inflammatory bowel disease, colorectal cancer or infectious diarrhea in patients who met symptom-based criteria to be less than 1%. The one disease that these patients were at higher risk for having was celiac disease.

What does all of this mean for you? It means that if you have no alarm symptoms, meet the criteria for IBS, and have been tested and do not have celiac disease, than the odds are very much in favor that you have IBS and not something else. That 98% figure should give you some reassurance even when your symptoms are at their most nightmarish. And letting go of the anxiety that your doctors have missed the “real problem” can only have a beneficial effect on your troubled digestive system.

_Sources:

Cash, B., Schoenfeld, P., & Chey, W. “The utility of diagnostic tests in irritable bowel syndrome patients: a systematic review” The American Journal of Gastroenterology 2002 97: 2812–2819.

Spiegel, B. “Diagnostic Testing in Irritable Bowel Syndrome: Theory vs. Reality” IFFGD Digestive Health Matters 17:14-16.