# new info on diagnosis



## trbell (Nov 1, 2000)

dont know if the link will work but this is from webmd and is a list of recent abstracts: http://mp.medscape.com/cgi-bin1/flo/y/haqM0ELqdr0Dz70FWNX0AY tom


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## SteveE (Jan 7, 1999)

It seems to want me to register or login. Can you summarize for us?


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## Kathleen M. (Nov 16, 1999)

AFAIK registration is free, and this site isn't much into the giving you out to spammers..The link is for a list of articles about diagnosing IBS.I'll leave the title/source and a sentance or two from each abstract


> quote:The Utility of Diagnostic Tests in Irritable Bowel Syndrome Patients: A Systematic ReviewCash BD, Schoenfeld P, Chey WDAm J Gastroenterol. 2002;97:2812-2819Conclusions: There is insufficient evidence to recommend the routine performance of a standardized battery of diagnostic tests in patients who meet symptom-based criteria for IBS. Based upon the increased pretest probability of celiac disease, routine performance of serological tests for celiac disease may be useful in this patient population, though additional study is needed in this area.Utility of the Rome I and Rome II Criteria for Irritable Bowel Syndrome in US WomenChey WD, Olden K, Carter E, Boyle J, Drossman D, Chang LAm J Gastroenterol. 2002;97:2803-2811Conclusions: Rome I was more sensitive than Rome II in this community sample of female IBS patients. Rome I/II do not necessarily identify the same IBS patients. These findings have important implications for clinical research in IBS patients and raise questions about whether the Rome II criteria are sensitive enough to be useful in clinical practice.New Developments in the Diagnosis and Treatment of Irritable Bowel SyndromeLongstreth GF, Drossman DACurr Gastroenterol Rep. 2002;4:427-434Symptom criteria are of paramount importance in diagnosis, but differences among the Manning, Rome I, and Rome II criteria may lead to variable identification of people with the disorder. Practice guidelines are based on evidence and, to a greater degree, on consensus; therefore, experts vary on the specifics of ordering particular diagnostic tests. There is an overlap of IBS symptoms with those of celiac sprue, and selected patients should be tested for the latter disease. Development and documentation of effective therapy has been difficult, but depending on the selection of subgroups, there is evidence for usefulness of smooth muscle relaxants, loperamide, and antidepressants. Various forms of psychological therapy and new serotonin-modulating agents seem especially promising. The placebo effect of the physician-patient relationship has important therapeutic benefit.Clinical Assessment of Irritable Bowel SyndromeLembo TJ, Fink RNJ Clin Gastroenterol. 2002;35:S31-S36There are three diagnostic criteria that may be used in the IBS diagnosis: Manning, Rome I, and Rome II. Although there is discrepancy about which is most effective, we recommend that the Rome II be used in clinical practice. To confidently diagnose IBS, the physician must rule out organic disease as a cause of symptoms. This can be done by evaluating the patient's symptoms and screening for "red flags." Use of Surrogate Markers of Inflammation and Rome Criteria to Distinguish Organic From Nonorganic Intestinal DiseaseTibble JA, Sigthorsson G, Foster R, Forgacs I, Bjarnason IGastroenterology. 2002;123:450-460Conclusions: Fecal calprotectin, intestinal permeability, and positive Rome I criteria provide a safe and noninvasive means of helping differentiate between patients with organic and nonorganic intestinal disease.Rectal Distention Testing in Patients With Irritable Bowel Syndrome: Sensitivity, Specificity, and Predictive Values of Pain Sensory ThresholdsBouin M, Plourde V, Boivin M, et alGastroenterology. 2002;122:1771-1777Conclusions: Lowered rectal pain threshold is a hallmark of IBS patients. Rectal barostat testing is useful to confirm the diagnosis of IBS and to discriminate IBS from other causes of abdominal pain.Diagnosis of Irritable Bowel SyndromeOlden KWGastroenterology. 2002;122:1701-1714A review of the literature shows that, in patients with no alarm symptoms, the Rome criteria have a positive predictive value of approximately 98%, and that additional diagnostic tests have a yield of 2% or less.


K.


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