Diagnosis and Assessment Figure 2. Diagnosis of IBS
Patient with recurrent abdominal pain or discomfort and altered bowel habit
Rome criteria YES
NO
• Rectal bleeding • Anemia • Weight loss • Fever • Family history of colon cancer • Onset of first symptom after 50 y of age • Major change in symptoms
Warning signs/Alarm features NO ≥ 50 years
Serologic testing for celiac sprue in patients with IBS-D
–
No further evaluation
+
Full evaluation for celiac sprue
– Selective YES
• Complete cell count • Blood chemical studies • Measurement of thyrotropin levels
Further evaluation needed
• Stool testing for occult blood and ova and parasites
other symptom-guided diagnostic testing
Colonoscopy and – IBS diagnosis confirmed
symptom-guided evaluation
Appropriate
Adapted from Mayer EA. Used with permission.
