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Symptom criteria for irritable bowel syndrome

Authoring team

A formal diagnostic criteria for IBS has been developed in the form of the Rome II criteria (1):

At least 12 weeks, which need not be consecutive, in the preceeding 12 months of abdominal discomfort or pain that has two of the three features:

  • relieved by defecation, and/or
  • associated with change of frequency of stool and/or
  • associated with change of consistency of stool

The following cumulatively support the diagnosis of IBS:

  • more than three motions per day
  • less than three motions per week
  • hard or lumpy stools
  • loose or watery stools
  • straining during a bowel movement
  • urgency
  • feeling of incomplete emptying
  • passing mucus during a bowel movement
  • abdominal fullness, bloating or swelling

 

Red flag symptoms that indicate need for colonoscopy in patients with suspected irritable bowel syndrome (2):

  • age > 50 years
  • weight loss
  • occult blood in faeces
  • family history of colorectal cancer

 

Reference:

  1. Thompson W.G. et al (1999). Functional bowel disorders and functional abdominal pain. Gut 45 supplement II: II43–II47.
  2. Hatlebakk J.G, Hatlebakk M.V (2004). Diagnostic approach to suspected irritable bowel syndrome. Best Practice & Research Clinical Gastroenterology;18(4):735-746.

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