Skip to main content
PMC home page
Gut logoLink to Gut
. 1991 Jul;32(7):784–786. doi: 10.1136/gut.32.7.784

More accurate diagnosis of irritable bowel syndrome by the use of 'non-colonic' symptomatology.

D G Maxton 1, J Morris 1, P J Whorwell 1
PMCID: PMC1378996  PMID: 1855685

Abstract

The criteria now used in an attempt to distinguish irritable bowel syndrome from organic gastrointestinal disease rely almost entirely on symptoms of colonic origin. 'Non-colonic' symptoms, however, arising either from elsewhere in the gut or of a more general nature, are common in irritable bowel syndrome and may have even better diagnostic potential. The prevalence of these non-colonic features was assessed in 107 patients with the irritable bowel syndrome and 295 subjects with other gut disorders. Gastrointestinal type non-colonic symptoms are useful in differentiating irritable bowel syndrome from inflammatory bowel disease but, with the exception of early satiety, are not helpful when there is gastro-oesophageal or biliary disease. More general 'non-colonic' features, such as lethargy and backache, are much commoner in irritable bowel syndrome than in all the organic gastrointestinal diseases studied and have good discriminant function. Multiple logistic regression analysis identified certain features that had a particularly significant independent risk for irritable bowel syndrome. Those were lethargy (relative risk 6.7), incomplete evacuation (RR 5.2), age under 40 (RR 2.1), backache (RR 2.0), early satiety (RR 1.8), and frequency of micturition (RR 1.8). These relative risks can be multiplied together to give an overall risk when more than one of these features is present in a patient. Until a diagnostic test is available more confident diagnosis of irritable bowel syndrome can be achieved by identifying symptoms that have good discriminant function. The results of this study indicate that the non-colonic features of irritable bowel syndrome may be especially valuable in this respect.

Full text

PDF
784

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Creed F., Guthrie E. Psychological factors in the irritable bowel syndrome. Gut. 1987 Oct;28(10):1307–1318. doi: 10.1136/gut.28.10.1307. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Kellow J. E., Phillips S. F. Altered small bowel motility in irritable bowel syndrome is correlated with symptoms. Gastroenterology. 1987 Jun;92(6):1885–1893. doi: 10.1016/0016-5085(87)90620-2. [DOI] [PubMed] [Google Scholar]
  3. Kruis W., Thieme C., Weinzierl M., Schüssler P., Holl J., Paulus W. A diagnostic score for the irritable bowel syndrome. Its value in the exclusion of organic disease. Gastroenterology. 1984 Jul;87(1):1–7. [PubMed] [Google Scholar]
  4. Kumar D., Wingate D. L. The irritable bowel syndrome: a paroxysmal motor disorder. Lancet. 1985 Nov 2;2(8462):973–977. doi: 10.1016/s0140-6736(85)90525-2. [DOI] [PubMed] [Google Scholar]
  5. Manning A. P., Thompson W. G., Heaton K. W., Morris A. F. Towards positive diagnosis of the irritable bowel. Br Med J. 1978 Sep 2;2(6138):653–654. doi: 10.1136/bmj.2.6138.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Maxton D. G., Morris J. A., Whorwell P. J. Ranking of symptoms by patients with the irritable bowel syndrome. BMJ. 1989 Nov 4;299(6708):1138–1138. doi: 10.1136/bmj.299.6708.1138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Talley N. J., Phillips S. F., Melton J., 3rd, Wiltgen C., Zinsmeister A. R. A patient questionnaire to identify bowel disease. Ann Intern Med. 1989 Oct 15;111(8):671–674. doi: 10.7326/0003-4819-111-8-671. [DOI] [PubMed] [Google Scholar]
  8. Talley N. J., Phillips S. F., Melton L. J., Mulvihill C., Wiltgen C., Zinsmeister A. R. Diagnostic value of the Manning criteria in irritable bowel syndrome. Gut. 1990 Jan;31(1):77–81. doi: 10.1136/gut.31.1.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Thompson W. G. Gastrointestinal symptoms in the irritable bowel compared with peptic ulcer and inflammatory bowel disease. Gut. 1984 Oct;25(10):1089–1092. doi: 10.1136/gut.25.10.1089. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Whorwell P. J., Clouter C., Smith C. L. Oesophageal motility in the irritable bowel syndrome. Br Med J (Clin Res Ed) 1981 Apr 4;282(6270):1101–1102. doi: 10.1136/bmj.282.6270.1101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Whorwell P. J., McCallum M., Creed F. H., Roberts C. T. Non-colonic features of irritable bowel syndrome. Gut. 1986 Jan;27(1):37–40. doi: 10.1136/gut.27.1.37. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES